"Outdated and unfair" NHS policy on second stem cell transplants

A second stem cell transplant can offer patients with blood cancer another chance at survival if their disease returns after a first transplant.

However, under NHS England’s current policy, that was introduced almost a decade ago in 2017, if a patient relapses less than 12 months after their first stem cell transplant, they will not be allowed a second one. This leaves some patients with no more options other than palliative care or funding their own treatment.

This policy no longer reflects advances in transplantation and modern clinical practice and urgently needs changing.

Evidence now shows that decisions around a second stem cell transplant should consider individual circumstances, rather than a fixed 12 month cut off. This approach is already used in other European countries, including Germany, where patients are assessed on an individual basis when considering if they are eligible for a second stem cell transplant.

Charities Anthony Nolan, DKMS UK and Leukaemia UK have launched a joint campaign calling on NHS England to update the policy, so that no patient is denied a potentially lifesaving stem cell transplant just because they can’t afford it.

For patients like Ruth Wake, 58, this policy has already had devastating consequences. After relapsing nine months after her first stem cell transplant for acute myeloid leukaemia (AML), Ruth was told that once her temporary treatment stopped working, she would go into palliative care, despite her clinicians believing a second transplant was worth pursuing.

Refusing to give up, Ruth was able to access a second stem cell transplant through a private healthcare provider. The treatment was successful and she is currently recovering.

Ruth said: “To be given the news you’ve relapsed is bad but then to find that decisions have been made on data that is way out of date doesn’t make sense. I know there are no guarantees that my leukaemia won’t come back again but this gives me extended time with my family when otherwise I would have had nothing.”

Other patients have had to rely on public fundraising. Faith Hinitt, 28, was diagnosed with AML in 2023. When her cancer returned following her initial stem cell transplant, Faith was left with no other option but to set up a GoFundMe page to raise hundreds of thousands of pounds for a second transplant.

“This campaign is about ending a blanket rule that can shut the door on a patient’s last realistic chance of survival.”

Yasmin Sheikh, Head of Policy and Public Affairs at Anthony Nolan, said: “Transplant medicine has moved forward significantly in recent years, yet the current policy is outdated and unfair, leaving some patients having to raise hundreds of thousands of pounds to access a treatment that could give them another chance at life. Nearly a decade ago, Anthony Nolan successfully campaigned to stop NHS England withdrawing access to second stem cell transplants altogether. That campaign secured an important policy change, but medicine has not stood still. Now NHS England must update its policy so clinicians can make decisions based on the latest evidence and what is right for each patient.”

Michael Gallagher, Policy and Public Affairs Manager at DKMS UK, said: “This campaign is about ending a blanket rule that can shut the door on a patient’s last realistic chance of survival. Some patients are ruled out before their individual circumstances are considered, simply because their disease returned before the 12-month mark. Timing of relapse matters, but it should inform a clinical decision, not dictate it. We are not calling for automatic access to a second transplant, but for an end to automatic exclusion. NHS England should replace this outdated cut-off with a transparent, risk-stratified process based on evidence, clinical need, and expert judgement, not a rigid deadline or a family’s ability to pay.”

Georgia Papacleovoulou, Head of Policy and Advocacy at Leukaemia UK, said: “For patients with relapsed blood cancer, a second stem cell transplant can be their only chance of survival. Treatment decisions should be based on clinical need and no patient should have to turn to private healthcare or fundraising for a live-saving treatment. It’s time this outdated policy was updated so that all patients can access the treatment they need.”

As part of the campaign, the charities have launched a joint petition calling on NHS England to review and update its policy.

Sign the petition today and give more people another chance of survival