How does ethnicity affect your likelihood of finding a match?

At Anthony Nolan, our vision is that all patients have the best access to, experience of, and outcome from a stem cell transplant or cell therapy.

We know that right now, not everyone has an equitable experience of treatment. Some patients face additional challenges or barriers to access, have a poorer experience, or face worse outcomes because of their background, circumstances or identity.

One issue that Anthony Nolan is particularly focused on is that, in the UK, patients from a minority ethnic background are more likely to have a tissue type that is rare or even completely unique. This can make it harder to find a well-matched unrelated donor if they need one.

This doesn’t necessarily impact the chances of these patients having treatment. A matched, unrelated donor is just one of the options available to people who need a stem cell transplant or cell therapy. Cells taken from a relative (which could be either a fully-matched sibling, or a ‘half-matched’ parent or sibling) or umbilical cord blood can also be used. Cell therapies like CAR T-cell therapy use the patient’s own cells, so don’t need a matching donor at all. You can learn more about the different types of stem cell transplant here.

In fact, when transplants from all kinds of donor are considered, patients of all ethnic backgrounds have a similarly good chance of finding a donor option for a stem cell transplant. For patients from a minority ethnic background 95% had access to a suitable source of stem cells and for patients from British Irish Northern European background it was 97%.

How is Anthony Nolan working to make cell therapies more equitable?

While it’s undoubtedly positive that nearly everyone can access a stem cell transplant donor if they need one, we still want to make sure everyone has the best chance of surviving and thriving.

That’s why improving equity for people in need of a stem cell transplant or cell therapy is a core part of our work, and one that we tackle in multiple ways:

Diversifying the donor register: We use evidence-backed recruitment strategies and are committed to increasing the number of people from minority ethnic backgrounds on our register to help give everyone the best chance of a match. In 2024/25, 29% of people added to the Anthony Nolan register were from a minority ethnic background.

Building up the cord blood bank: In 2008 we opened the UK’s first dedicated cord blood bank to store donated umbilical cord blood, which requires less stringent matching and can offer patients without a full match another option for transplant.

Carrying out research into new treatments: Our researchers are investigating cell therapies that don’t require stringent genetic matching, and researching ways to reduce side effects like graft versus host disease (GvHD), which could give more options to patients without full matches.

Influencing policy: Our campaigning helps improve equity of access to therapies and champions best practice care for all. And we work to support the development and roll-out of new cell and gene therapies in the UK, which don’t require genetic matching.

We also keep a close eye on the work that is ongoing internationally to help improve outcomes for patients without a full match. One major area of research is a treatment called post-transplant cyclophosphamide, or PTCy. This is where a medicine called cyclophosphamide is given after a stem cell transplant to help reduce the risk of GvHD, especially in patients who don’t have a fully matched donor.

So far, research from the US has indicated that PTCy could improve survival from transplants using a mismatched donor. This could drastically widen the available donor pool for patients with rarer tissue types, so could make a huge impact on healthcare inequities.

Your questions answered

What are my chances of finding a matching donor if I’m from a minority ethnic background?

In the UK, patients from a minority ethnic background are more likely to have a tissue type that is rare or even completely unique on UK registers. This can make it harder to find a well-matched unrelated donor if they need one.

There is no up-to-date analysis on how the likelihood of finding a well-matched unrelated donor differs based on ethnicity. However, there are other options available like using cells taken from a relative (a ‘half-matched’ or haplo-identical donor) or umbilical cord blood which can withstand a lower degree of matching.

In fact, when transplants from all kinds of donor are considered, patients of all ethnic backgrounds have a similarly good chance of finding a donor option for a stem cell transplant. For patients from a minority ethnic background 95% had access to a suitable stem cells and for patients from British Irish Northern European background it was 97%.

Does my donor need to have a similar heritage to me?

Patients are more likely to find a successful match from someone of a similar heritage, but a donor match could be from any ethnicity or heritage.

Currently, two-thirds of registered donors worldwide are from Europe and North America, which is why we need to increase the number of people on registers from under-represented populations.

What if there isn’t a donor on the UK register for me?

We work with registries around the world to help find patients their very best available donor, wherever they are.

If there is no available match in the UK, we search international registries via the World Marrow Donor Association (WMDA), which operates in 55 countries and provides access to over 40 million adult donors and more than 800,000 cord blood units. Given the huge genetic diversity in people’s tissue types, it’s not unusual that a patient’s best match will be based outside the UK. A patient’s medical team will also look into other sources, like any relatives who could donate, or cord blood options.

Whether they are coming from the UK or internationally, we coordinate the collection and safe transportation of cells to the patient.

Why are people from minority ethnic backgrounds in the UK more likely to have a rare or unique tissue type?

Stem cell matching is based on a person’s tissue type, which is determined by their HLA genes. HLA genes are incredibly varied because they help the immune system recognise potential infections – and the more variations that exist in a human population, the more potential infections the population can detect and destroy.   

HLA genes have evolved over time based on factors like the kinds of infections a population has encountered, and how populations have migrated across the world. The links between ethnicity and geographic location may therefore be a reason why some ethnic groups have more variation in their HLA genes, and are more likely to have a rare or unique tissue type.

We're here to support you

We understand it can still be concerning that you might be less likely to have a full match on the stem cell register if you’re from a minority ethnic background.

We’re here to help you if you’re worried about this. Below, we’ve answered some questions which you may find useful. Or you can call our helpline or contact us for information, advice or emotional and practical support for you and your family.