Dr Matthew Wilson and Dr Kate Cwynarski discuss the Central nervous system prophylaxis in large B-cell lymphoma Good Practice Paper, published in 2024.

Professor Christopher Fox, Dr Sridhar Chaganti and Dr Bernard Maybury discuss the Management of relapsed or refractory large B-cell lymphoma Guideline, published in 2025.

This podcast is the first of a series of three recordings of the Lymphoma Special Interest Group (SIG) Education Session at the 2025 BSH Annual Scientific Meeting.  The Lymphoma SIG is delighted to share talks from three great speakers with the wider audience.

In this recording, Dr David Lewis discusses first-line treatment for mantle cell lymphoma in 2025, focusing on three main themes: 1) the emerging use of Bruton’s tyrosine kinase inhibitors (BTKis) in first-line treatment, 2) the role of autologous stem cell transplant, and 3) the clinical utility of minimal residual disease (MRD).

Dr David Lewis is a Consultant Haematologist at the University Hospitals Plymouth and an Honorary Associate Professor at the University of Plymouth.  He is the Chief Investigator of the ENRICH trial – a randomised, open-label study of Rituximab/Ibrutinib versus. Rituximab/Chemotherapy in older patients with untreated mantle cell lymphoma.

Dr Cathy Burton chaired the “Top Abstracts in Lymphoma” session at BSH 2025.  In this episode, she shares with us the highlights from this session.

Dr Burton is a Consultant Haematologist at St James’s University Hospital, Leeds, specializing in Lymphoma and Diagnostics. She is heavily engaged in translational research in lymphoma and is Chair of the Hodgkin lymphoma study group, Deputy Chair of the Lymphoma Science study group and a member of the UK Lymphoma Research Group. She has recently been involved in writing the diffuse large B cell lymphoma guidelines and is the chair of the BSH Lymphoma Special Interest Group.

Dr Dima El-Sharkawi is a Consultant Haematologist at the Royal Marsden Hospital in Sutton. Her special interests are in CLL, rare leukaemias and lymphomas as well as early phase trials and drug development. She has been an investigator on a number of clinical research studies in these disease groups. She is clinical lead of the Specialist Integrated Haematological Malignancy Diagnostic Services at The Royal Marsden.  She is a member of the UK lymphoma research group and CLL trials groups and has co-authored national guidelines for the diagnosis and management of T cell lymphoma and Waldenstrom macroglobulinaemia.

Dr Tracey Chan and Dr Jennifer Pinney discuss the Diagnosis and management of monoclonal gammopathy of renal significance Good Practice Paper, published in January 2025.

In this episode, Dr Sridhar Chaganti shares with us the highlights in large B-cell lymphoma from BSH 2025, including real-world experience in the use of bispecific antibodies and the recent NICE approval of Lisocel as second line treatment.

Dr Chaganti is a Consultant Haemato-oncologist at the University Hospital in Birmingham, with an interest in lymphomas, ALL, stem cell transplantation and immune effector cell therapies including CART cell therapy.  He is the chair of the high-grade lymphoma study group and co-chairs the national CAR-T panel.

Presenters: Sean Platton (Consultant Biomedical Scientist) and Peter Baker (Clinical Scientist and the Laboratory Lead for Haemostasis)

Measurement of heparin, direct oral anti-coagulants and other non-coumarin anti-coagulants and their effects on haemostasis assays: A British Society for Haematology Guideline

This guideline aims to update healthcare professionals working in the UK on the measurement of anti-coagulants (other than coumarins) currently licensed for use in the UK, and their effects on laboratory assays (Table 1). It provides recommendations based on the body of literature produced since the previous guidance published in 2014.1 Direct factor (F)XIa- and direct FXIIa-inhibiting anti-coagulants are at various stages of development but not yet licensed, so are not discussed in this guideline.2 The recent guidelines from the International Society of Thrombosis and Haemostasis Scientific Standardization Committee (ISTH/SSC) on the nomenclature to be used when describing non-vitamin K anti-coagulation3 are followed.

Some anti-coagulants, such as unfractionated heparin (UFH) and argatroban, have been in clinical use for decades. Laboratory monitoring to guide dose adjustments has been with the widely available activated partial thromboplastin time (APTT). However, the COVID-19 pandemic highlighted the wide variability in the sensitivity of different APTT reagents in patients with acute illness, emphasising the need for accessible and cost-effective anti-FIIa and anti-FXa assays for routine monitoring.

The introduction of specific anti-FIIa or anti-FXa-based assays has provided a means to quantitate plasma drug concentrations of the newer fixed-dose FIIa inhibitors (FIIaI) and FXa inhibitors (FXaI). When used according to licence, monitoring these direct oral anti-coagulants (DOACs) is not required, but measuring drug concentration can add value in some circumstances (Table 2). As neither drug concentration nor dose-adjustment based on the measured concentration has yet been shown to affect efficacy or safety, it is incorrect to refer to a therapeutic range. In this manuscript, the term ‘expected range’ is used to acknowledge this limitation.

There are many reports in the literature about the effects of anti-coagulants on measurable parameters of haemostasis. Lack of awareness of these effects, which are variable depending on anti-coagulant, timing of sampling and reagents, can cause confusion and delay diagnosis and care. Table 3 gives a broad overview of the types of impact on laboratory assays that may be seen.

All assays described must be used in accordance with requirements of ISO15189.

In this episode, Professor Graham Collins shares with us the highlights in Hodgkin lymphoma from BSH 2025.  He takes us through the ECHELON-1 trial, which led to the recent NICE approval of Brentuximab-AVD as a frontline treatment option for advanced stage Hodgkin lymphoma.