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HENNY BRAUND: WHAT DOES THE FUTURE HOLD FOR STEM CELL TRANSPLANT RECIPIENTS?

Here, Anthony Nolan’s Chief Executive, Henny Braund, gives an overview of current and emerging treatments for blood cancer and the developments needed to give patients the best chance of life. This blog post is adapted from an interview recently given by Henny Braund for The Economist’s World Cancer Series: Europe Virtual Week. You can watch the full interview here.

In the UK and across Europe, providing access to personalised care and support for cancer patients is a key, emerging priority. The opportunity to receive personalised care not only increases someone’s likelihood of surviving cancer but their quality of their life throughout and after receiving treatment.

Every year, around 40,000 people in the UK are diagnosed with blood cancer. With treatments being made both more efficient and more effective, and developments in immunotherapy, now is the time to ensure government, healthcare systems and industry are ready to deliver cancer care fit for the 21st Century. As we renew our healthcare services following this pandemic, it is critical that we involve blood cancer and stem cell transplant patients in this process to ensure we’re building back better.

Personalised medicine is already here

For many blood cancer patients, access to personalised medicine has already been a reality for decades. Stem cell transplants can be used to treat a wide range of blood cancers and blood disorders. The Anthony Nolan stem cell register includes over 800,000 potential donors, and as part of our donor search and selection process, we compare a recipient’s tissue type to donors across the UK and the rest of the world.

Understanding a person’s genetic information to find their best stem cell donor match lies at the heart of what Anthony Nolan does. Thanks to our amazing stem cell donors, we were able to provide stem cells to nearly 1,500 patients in the last year. This means that, every day, we give four people a precious chance of life.

With the first generation of cellular therapies now arriving, some blood cancer patients can now access CAR-T (Chimeric Antigen Receptors Cell Therapy) through the NHS. By reprogramming a patient’s own immune system, cells are then used to target their cancer. Alongside stem cell transplants, these therapies offer another means of treatment, although both options can carry significant side-effects and cellular therapies will require mass re-training of the healthcare workforce.

To support the next generation of therapies, Anthony Nolan is building new partnerships with industry and researchers through our Cell and Gene Therapy Services, along with our support of IMPACT, the UK’s stem cell transplant clinical trials partnership. Together, we are exploring how we can improve patient outcomes and reduce side-effects such as GvHD and toxicity.

COVID-19 is our opportunity to learn and improve

2020 has been a year like no other and transplant services in the UK have had to change the way they deliver care and support to patients with blood cancer and blood disorders. The sense of uncertainty we’re all feeling is even greater for those in need a transplant or in the process of recovering.

Many transplant centres have turned to remote appointments, which has helped maintain patients’ connection with their healthcare teams. A recent survey of transplant recipients during the pandemic showed 60% of those who have experienced a remote appointment stated that they were able to access the care they needed from it.

However, face-to-face appointments were still seen as a preferred option by numerous respondents, as many side effects of transplant can only be picked up in-person. Couple this with the fact that access to video calls is not the norm for all patients, and the need to be led by patient choice is paramount to delivering quality care during these difficult times.

Times of great change can lead to great innovations. With this in mind, many clinicians are already considering what this means for the transformation of transplant care and wider healthcare systems. Such change cannot be used as a route to save money – to deliver more for less – because patient needs are only increasing and a blended delivery of high-quality clinical services will still require appropriate funding.

We need to support the whole patient

Of the many changes we must embrace is the necessity to build person-centred care and services around patients, rather than the teams and settings that provide them. After all, a blood cancer patient’s experience is more than a series of consultations, blood tests or conditioning treatments ahead of a stem cell transplant.

It’s encouraging to see that both the NHS Long Term Plan and the EU Commission’s Beating Cancer Plan have both prioritised the best possible quality of life for patients, survivors and carers. We need to stop segmenting patients and instead look at their physical, psychological, social and economic needs as they receive treatment and begin their recovery.

Anthony Nolan’s Pathway for Post-Transplant Care has sought to address this problem by describing the services and support packages which are central to the recovery of patients. Transplant recipients deserve access to clinical psychologists, experienced Clinical Nurse Specialists (CNSs) as well as proper integration with primary care. The provision of these services will give them the best chance of managing a range of physical and psychological late-effects.

The COVID-19 pandemic has highlighted the importance of medical research and healthcare among policymakers and the general public. Now is our opportunity to renew our healthcare services and, by involving patients in rebuilding and reshaping our services, help realise a better quality of life for all blood cancer and blood disorder patients.

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