The NHS England policy for second transplants
Unfortunately, sometimes diseases like blood cancer can come back after a first stem cell transplant.
In those cases, a second stem cell transplant might be the best chance a patient has.
Under NHS England's current policy, patients are eligible for a second transplant funded by the NHS if they relapse more than 12-months after their first donor transplant.
This means patients who relapse within a year are generally excluded from an NHS-funded second transplant, regardless of their general health or response to treatment.
We believe this policy, which was created in 2017, is outdated and needs to change. NHS England’s policy puts England out of step with other European countries, many of whom make decisions on second transplants based on the patient's individual situation, rather than a set timeframe since the initial transplant. Â
That's why Anthony Nolan, Leukaemia UK and DKMS are jointly calling for NHS England to update its policy so decisions on second transplants can be made on an individual basis.
Our call for an updated policy
In 2017, Anthony Nolan campaigned for second transplants to be routinely funded for patients who relapse more than one-year after their first transplant, after it was announced in 2016 that second stem cell transplants were 'not currently affordable'.
At the time, there was weak evidence for the effectiveness of second transplants for patients who relapse within a year of their first transplant.
Now, emerging data suggests outcomes from a second transplant under 12-months after relapse have improved, especially when the patient's individual circumstances like their disease type and underlying health are considered.
Yasmin Sheikh, head of policy and public affairs at Anthony Nolan said:
"For people whose blood cancer returns after a stem cell transplant, a second transplant can be lifesaving. Yet, under NHS England’s current policy, if patients relapse within 12-months of their first transplant they are not eligible for a second stem cell transplant. It means some people are forced to crowd-fund hundreds of thousands of pounds for potentially lifesaving treatment.
"We believe this policy is outdated and needs to change. NHS England’s policy was introduced in 2017. Since then, transplant medicine has advanced significantly, with growing evidence showing that decisions about a second transplant should be more personalised, taking factors like a patient’s underlying health into account, rather than being based on an arbitrary time threshold alone.
"NHS England is out of step with other European health systems, where a patient’s eligibility for transplant is based on their individual circumstances. In England, however, access to potentially lifesaving treatment continues to be determined by a policy that is almost a decade old.
“Anthony Nolan, DKMS and Leukaemia UK are calling on NHS England to urgently review its policy on second transplants to ensure it reflects the latest clinical evidence, so that no patient is denied a potentially lifesaving stem cell transplant just because they can’t afford it.”
What does this mean for patients?
We understand it can be worrying to hear that you may not be eligible for a second transplant if your disease comes back within one year of your first donor transplant.
Your medical team will monitor you closely after treatment to address any problems as soon as they notice them. If your transplant hasn't worked, they will usually offer other treatments to help.
You can read more about these other treatments, and why a transplant may not work, here.
We're here to support you if you you're worried about this or any other aspect of your stem cell transplant.
You can contact our Patient Services team by phone, email or web enquiry, and find other support services here.