Improving the donor experience
Since Anthony Nolan was founded in 1974, we’ve facilitated over 31,100 transplants for people around the world. Those transplants wouldn’t be possible without the people who selflessly donated their cells to help a person in need.
Over the decades, we have carried out research and implemented cutting-edge technologies to not only make it easier for potential donors to join the register, but to make their donation process simpler too.
We are committed to continually improving their journey before, during, and after donation. Their generosity is at the heart of everything we do. Without our donors, we could not give four people every day another chance at life.
The evolution of our register sign-up process – from blood tests to saliva
When the Anthony Nolan register was founded in 1974, it was the first of its kind in the world, and the most effective way to test someone’s tissue type was through a blood sample.
While effective, it was far from ideal. Blood collection required a trained phlebotomist, and blood samples had to be kept at low temperatures and processed within 24 hours. This was because the tissue typing needed to be performed on live cells. If the blood was not processed in time, these cells would die.
While necessary to give people their lifesaving transplants, this method created logistical and financial challenges - we knew there had to be a better way.
In 2010, Anthony Nolan researchers discovered that DNA extracted from saliva could provide a high-quality sample for tissue typing. This meant instead of requiring blood samples collected in clinical settings, potential donors could now provide a simple saliva sample, making the recruitment process easier, quicker and far more accessible.
With this breakthrough in knowledge, we decided to convert entirely to a system where potential donors could spit into a plastic tube, which contained a preservative to protect the contents of the sample for several years. The tube was then sent back to the Anthony Nolan laboratory, where staff could determine the tissue type.
This new method created a revolution in the way potential donors could join the register.
Recruitment events became easier and more cost-effective to run as a trained phlebotomist was no longer required. Instead, volunteers up and down the country could hold recruitment events and saliva swabs could simply be sent in the post – overall, joining the register became far easier.
In the years that followed, sequencing technology became more sensitive and accurate, and in 2017 our researchers discovered we could extract enough DNA from a simple cheek swab to successfully tissue type our donors. This method is cheaper and more efficient that taking a blood or saliva sample, meaning resources can be used to add more potential donors to our register.
Improving the donation process - from bone marrow to blood
It’s safe to say we’ve come a long way when it comes to making it easier for potential donors to join the register, but we wanted the process of donating to become easier too.
When our charity was founded, the first successful bone marrow transplant involving an unrelated donor and patient had taken place just one year earlier, in 1973. A bone marrow donation is where stem cells are collected directly from the bone marrow in the pelvis and requires a general anaesthetic.
In the 1990s, new techniques started to be developed which had the potential to improve bone marrow transplantation. One was the use of stem cells collected from peripheral blood, or PBSC as it became more commonly referred to.
Stem cells are found in the bone marrow and are the ‘parent cells’ that create new blood and immune cells. Through research, it became clear that these parent cells could be ‘mobilised’ into the blood stream. This is done by giving the donor four or five injections of a natural bone marrow stimulating hormone called G-CSF (granulocyte-colony stimulating factor).
This meant the extra cells could be collected from the donor’s blood in a process which automatically extracts blood, pumps it into a special machine which collects the blood stem cells and then returns the rest of the blood to the donor.
For donors, PBSC donation offered many advantages over bone marrow donation, as it avoided the need for a general anaesthetic and a hospital stay, while also allowing for a faster recovery.
By the start of the new millennium, PBSC quickly became established as a viable method of donation. In 2000, 17 donors from the Anthony Nolan register donated using the PBSC method and by 2002, this increased to 131. Fast forward to today, and PBSC is used 90% of the time when donating for a patient.
Opening England’s first dedicated cell collection centre
While joining the register and donating stem cells is now easier than ever, we are committed to going further. We want every donor to receive a world-class experience and to support research that helps us continually improve their journey.
In September 2025, we opened the first dedicated cell collection centre in England, located at Queen's Medical Centre, Nottingham. This has enabled us to not only collect stem cells from donors at a time that meets the need of the patient, but also to carry out research to ensure donors have the best possible experience.
One area of focus has been reducing the need for repeat donations. Around 30% of adults donating PBSCs to an unrelated patient need to return to their donation clinic for a second day to ensure enough cells are collected for a successful transplant. To help address this, we have been researching ways to identify and support donors who may be less likely to produce enough stem cells for collection in a single day.
Our senior medical officer, Dr Tania Dexter, has worked with the World Marrow Donor Association (WMDA) to develop official guidelines on the use of plerixafor, a stem cell mobilisation drug that can increase the number of stem cells available for collection in healthy donors. The publication of these guidelines provides collection centres with greater clarity on how and when to use the drug, which could enable more donors to successfully donate enough stem cells in a single collection session.
Alongside this, our clinical research team has developed a predictive model to identify donors who are most likely to provide enough stem cells in one day. The model is currently being evaluated at our cell collection centre before wider rollout and could help get stem cell donations to patients faster, free up valuable collection capacity and reduce the burden on donors. In the future, predictive tools like this could also help identify donors who may benefit from additional support, such as plerixafor, before collection begins.
“This work represents the early stages of us using our new cell collection centre to conduct donor-centric research, with the aim of improving the donation experience and making the transplant process faster and more efficient for both patients and donors.
“It’s exciting to see the new WMDA guidelines being shared with the wider stem cell community, encouraging collection centres to use plerixafor in cases where it can safely boost stem cell collection. We will continue to monitor the impact of these guidelines and the use of plerixafor, while exploring how predictive tools can further improve collection efficiency and donor outcomes.”
Dr Tania Dexter, senior medical officer and research lead
How can you help?
Even with nearly one million people on the register, we urgently need to increase the number and diversity of potential donors so that we can help as many people as possible who need a lifesaving stem cell transplant.
You could save a life by joining the stem cell register – your cells could be what a patient somewhere in the world is waiting for. You can join if you’re between 16-30, and it takes just a few minutes to fill out the form.