Children's haematology, blood and marrow transplantation

• Bone marrow transplants – sibling and matched family donor transplants, alternative donor transplants with unrelated matched and mismatched transplants, haploidentical transplants
• Level two care for paediatric oncology patients, including infusional, day care and bolus chemotherapy, supportive care and blood product transfusions
• Tertiary care for patients with haemoglobin disorders, including automated red cell exchange transfusions (erythrocytaphaeresis), top-up blood transfusions, hydroxycarbamide and iron chelation therapy, surgery, paediatric intensive care and 24 hour paediatric emergency department.

• Sickle Cell Society
• British Society of Blood and Marrow Transplantation
• Human Tissue Authority
• Public Health England
• NHS England
• Anthony Nolan Trust
• CLIC Sargent
• Thalassemia Society United Kingdom

Our paediatric haematology, blood and marrow transplantation unit at St Mary’s Hospital specialises in the care of children with haemoglobinopathies and red cell disorders, bone marrow transplantation and bone marrow failure syndromes.

We provide a comprehensive service for the medical management of children with sickle cell disease and thalassaemia, including a dedicated teenage and young adult transition service. We are the specialist haemoglobinpathy centre in the Paediatric Imperial Red Cell Network, providing tertiary services to local patients and outreach services to haemoglobinopathy patients at hospitals across north west London and the Thames Valley.

The Trust’s paediatric haemoglobinopathy service was ranked the top provider in terms of meeting national quality standards by the West Midlands Quality Review Service in their 2014–16 peer review of services for haemoglobin disorders. We have excellent ’cradle to adult’ care pathways for children with haemoglobin disorders, with robust transition services.

The bone marrow transplant unit has four dedicated transplant cubicles with HEPA filtration and positive pressure control. It carries out 34 to 37 allogeneic transplants a year (both related and unrelated donors) in children with thalassaemia, sickle cell disease, aplastic anaemia, Diamond Blackfan anaemia, Fanconi anaemia, dyskeratosis congenita and other inherited bone marrow failure syndromes. The transplant team has undertaken several innovative transplants using alternative donors for children with haemoglobinopathies and bone marrow failure.

After discharge from the inpatient ward, children are looked after by an expert multidisciplinary team on a dedicated, purpose-built day care unit which is reserved for immunocompromised patients and includes facilities for protective isolation. We also have a comprehensive and dedicated joint specialist service for long-term follow up for recepients of a bone marrow transplant with a consultant haematologist and consultant endocrinologist.

Our service includes the only level two shared care paediatric oncology unit (POSCU) in north west London and sees 20 to 25 new patients with malignancies each year. Patients are looked after by a specialist team led by paediatric haematology consultants with paediatric oncology clinical nurse specialists, in close association with Great Ormond Street Hospital and University College London Hospital. We offer all aspects of supportive care and day care chemotherapy for children.

The service also manages children with bleeding disorders and thrombotic problems. We offer specialist paediatric transfusion advice and provide high-level shared care for children with malignancies.

The team provides specialised care for:

• haemoglobinopathies – sickle cell disease and thalassaemia
• bone marrow failure
• bone marrow transplantation
• paediatric oncology
• general paediatric haematology
• haemostasis and thrombosis

• Bone marrow transplants – sibling and matched family donor transplants, alternative donor transplants with unrelated matched and mismatched transplants, haploidentical transplants
• Level two care for paediatric oncology patients, including infusional, day care and bolus chemotherapy, supportive care and blood product transfusions
• Tertiary care for patients with haemoglobin disorders, including automated red cell exchange transfusions (erythrocytaphaeresis), top-up blood transfusions, hydroxycarbamide and iron chelation therapy, surgery, paediatric intensive care and 24 hour paediatric emergency department.

• Sickle Cell Society
• British Society of Blood and Marrow Transplantation
• Human Tissue Authority
• Public Health England
• NHS England
• Anthony Nolan Trust
• CLIC Sargent
• Thalassemia Society United Kingdom

Our children's haematology, blood and marrow transplantation service holds clinics at St Mary's Hospital for children with sickle cell and thalassaemia.

Transfusion times

Transfusions are held during clinic hours and are only available by appointment.

Phlebotomy times

Blood tests are available during clinic hours and during opening hours for the paediatric haematology day unit. Blood tests are done via appointments only – please contact the clinical nurse specialist.

Haematology clinics in children's outpatients, St Mary's Hospital

Address:
Children's outpatients
6th floor
QEQM building
South Wharf Road
St Mary's Hospital
London W2 1NY

Adolescent haemoglobinopathy clinic

Hours: Second Tuesday of each month, 16:30 – 19:00
Contact: Clinical nurse specialist – 020 3312 3346
Dr Lund’s secretary – 020 3312 6157

General haematology clinic

Hours: Mondays, 13:30 – 16:30
Contact: Clinical nurse specialist – 020 3312 5096 / 2509
Dr Karnik's secretary – 020 3312 6164

Bone marrow transplant late effects clinic

Hours: Third Thursday of every quarter, 09:00 – 12:30
Contact: Clinical nurse specialist – 020 3312 5062 / 3345
Dr Karnik and Dr de la Fuente’s secretary – 020 3312 6164

Haematology clinics in the paediatric haematology day unit, St Mary's Hospital

Address:
Paediatric haematology day unit
6th floor, QEQM building
South Wharf Road
St Mary’s Hospital
London W2 1NY

Paediatric haemoglobinopathy clinic

Hours: Mondays, 13:30 – 16:30
Contact: Clinical nurse specialist – 020 3312 3346
Dr Lund’s secretary – 020 3312 6157

Paediatric haematology and ITP clinic

Hours: Thursdays, 13:30 – 16:30
Contact: Clinical nurse specialist – 020 3312 5023
Dr Cooper’s secretary – 020 3312 6157

Bone marrow transplant clinic

Hours: Wednesdays, 13:00 – 17:00
Contact: Clinical nurse specialist – 020 3312 5062 / 3345
Dr Karnik and Dr de la Fuente’s secretary – 020 3312 6164

Bone marrow failure clinic

Hours: Every other Thursday, 09:00 – 12:00
Contact: Clinical nurse specialist – 020 3312 5062
Dr de la Fuente’s secretary – 020 3312 6164

Paediatric oncology clinic

Hours: Tuesdays, 13:30 – 17:00
Contact: Clinical nurse specialist – 020 3312 5023
Dr Petterson’s secretary – 020 3312 6157

Our children's haematology, blood and marrow transplantation service is managed by a team of consultants and clinical nurse specialists.

Consultants

• Dr Josu de la Fuente – Consultant paediatric haematologist, director of blood and marrow transplantation service
• Dr Leena Karnik – Consultant paediatric haematologist, clinical lead
• Dr Toni Petterson – Consultant paediatric oncologist
• Dr Kirstin Lund – Consultant paediatric haematologist
• Dr Nichola Cooper – Consultant haematologist
• Dr Adam Gassas – Consultant paediatrician

Clinical nurse specialists

• Catherine Mkandawire – Matron for haemoglobinopathies and apheresis
• Ana Cabrera – Clinical nurse specialist, oncology and haematology
• Yvonne Harrington – Clinical nurse specialist, Diamond-Blackfan anaemia
• Kajal Rai – Clinical nurse specialist, haemoglobinopathies
• Nancy Huntley – Paediatric apheresis nurse specialist
• Ristell Fernandes – Paediatric apheresis nurse specialist

Paediatric bone marrow transplant coordinators

• Sandrine Bremathas
• Calum Lyon

Find out what to expect when you come to hospital for your child's haematology, blood and marrow transplantation appointment.

Before your appointment

Please remember to bring your child’s 'red book' to the appointment. This helps us check vaccinations and ensure your child is up to date.

If your child receives regular transfusions at another hospital and only visits us for reviews, please bring a handheld clinical record (if available), recent blood results, and a list of medicines and transfusions.

Some medicines can only be prescribed after a blood test. Please check your appointment letter for anything else to bring.

Also bring:

• Your full address and contact numbers
• Your appointment card and letter
• Your GP’s name and address
• Any questions you’d like to ask the consultant

During your appointment

Appointments last around an hour for new patients and 30 minutes for follow-ups. Blood tests may be needed after.

Our consultant will assess your child, and we’ll arrange as many investigations as possible on the same day to minimise visits. These may include TCD, spirometry, x-rays, ultrasounds, MRI, hearing tests, and psychology assessments.

We are a teaching hospital, so students may be present. You can ask for them to step out if preferred.

All clinics are supported by play specialists and a dedicated paediatric pharmacy service.

After your appointment

You will receive written guidance on follow-up appointments and contact numbers. A consultation summary will be sent to you, your referring doctor, and your GP.

Ward information

Children with sickle cell or thalassaemia are usually admitted to Great Western Ward. Those having a bone marrow transplant stay on Grand Union Ward.

Visit our wards page for visiting times, contact details, directions and more.

Patient leaflets

• Allogenic bone marrow harvest
• Autologous bone marrow harvest
• Automated red cell exchange
• Before your child has a stem cell transplant
• Bone marrow aspirate and trephine
• Children and sickle cell disease
• Children and thalassaemia
• Getting ready for transplant
• Transition clinic
• Haemoglobinopathy services
• Infusion of Desferal
• Liver biopsy: guide for families
• Pre-op testing for blood disorders
• Priapism in adolescents
• Priapism in children
• Returning to school after transplant
• Skin biopsy info
• Tissue typing (HLA)
• Transcranial Doppler scans (TCD)
• Vaccinations and travel
• Warfarin in children

Find out how to refer patients to our children's haematology, blood and marrow transplantation service.

GP referrals

Please use NHS e-Referrals. Bone marrow transplant and failure clinic referrals usually come from consultant paediatricians.

Infants identified via the neonatal haemoglobinopathy screening service are referred to our haemoglobinopathy clinic.

Two week wait cancer referral

Urgent cancer referrals can be made via the two week wait referral pathway.

GP enquiries

To discuss any paediatric haemoglobinopathy or haematology patient, please call 020 3312 6157.

• Allogenic bone marrow harvest – children
• Autologous bone marrow harvest – children
• Automated red cell exchange – children
• Before your child has a stem cell transplant
• Bone marrow aspirate and trephine – children
• Children and sickle cell disease
• Children and thalassaemia
• Getting ready for your child's bone marrow transplant
• Haematology transition clinic – children
• Haemoglobinopathy services at St Mary’s Hospital – children
• Infusion of Desferrioxamine Mesilate (Desferal) – children
• Liver biopsy – a guide for families
• Preoperative testing for blood disorders – children
• Priapism and sickle cell disease – adolescents
• Priapism and sickle cell disease – children
• Returning to school after a bone marrow transplant
• Skin biopsy – information for families
• Tissue typing (HLA typing)
• Transcranial Dopplers (TCD) – children
• Vaccinations, medication and travel – thalassaemia and sickle cell disease
• Warfarin anticoagulation in children

Find out how to refer patients to our children's haematology, blood and marrow transplantation service.

GP referrals

Please use NHS e-Referrals to refer a patient to this service.

Bone marrow transplant and bone marrow failure clinics usually receive referrals from consultant paediatricians.

Infants diagnosed via neonatal haemoglobinopathy screening are referred to the haemoglobinopathy clinic.

Two week wait cancer referral

Urgent cancer referrals can be made via the two week wait referral pathway.

GP enquiries

To discuss any paediatric haemoglobinopathy or haematology patient, please call 020 3312 6157.