30 years of research
To mark the 30th anniversary of the Anthony Nolan Research Institute (ANRI) we’re looking at some of our major research projects that are helping more people survive and thrive after a stem cell transplant.
At Anthony Nolan, our vision is that all patients have the best access to, experience of, and outcome from stem cell transplants.
We know that not everyone has equal access to stem cell transplants and cell therapies, and not all patients have the same quality of experience or likelihood of surviving without serious complications.
We won’t stop until every patient that needs treatment can not only survive, but thrive. Here’s how our research is contributing towards that future.
What needs to improve
Although survival rates after a stem cell transplant have improved over the years, we know there’s still a long way to go. Around 50% of people with blood cancer survive for five years or more after a stem cell transplant from a donor. Our own research has shown that for patients from minority ethnic backgrounds in the UK, outcomes can be worse. Black and Asian patients are 1.5 times more likely to die within five years of a donor transplant compared to White patients. We’re determined to change this.
We’re also investigating whether someone’s background or circumstances is linked to their chance of a smooth recovery following a transplant. Stem cell transplants can have a huge burden for patients on their financial, social, and mental wellbeing, and we know that factors like socioeconomic status and ethnicity have been linked to healthcare inequities. It’s important that we ensure similar inequities in stem cell transplantation are identified and addressed.
How Anthony Nolan's research is making a difference
We won’t stop until every patient that needs us can not only survive, but thrive.
Equity is one of Anthony Nolan’s three key aims in our organisational strategy, and as such is a key focus of several of our research projects – helping us move towards a future where every patient can survive and thrive.
And thanks to our expertise in transplant science, and close connections to patients and transplant centres, we are uniquely placed to uncover the causes of inequities and bring findings to the transplant community very quickly.
Addressing matching inequities
Generally, the better the match between a patient and donor’s tissue type, the more likely a patient will have a successful transplant. However, we know that UK patients from minority ethnic backgrounds are more likely to have rare tissue types on UK registers, which can make it harder to find a fully matched unrelated donor. This can mean they need to wait longer for a transplant, or are more likely to experience side effects like graft versus host disease (GvHD).
Recruitment drives powered by science
We have collaborated with the largest stem cell register in India, DATRI, in a targeted recruitment drive designed to diversify the global donor pool and improve matching inequities, including for UK patients with South Asian heritage.
This AN-DATRI Recruitment Project is a three-year pilot project that has recruited 10,000 additional donors from specific regions of India to the pool of international stem cell donors. Anthony Nolan researchers used data analysis to predict which areas in India we are most likely to find donors with tissue types that are less well represented on the global registry. The aim is to recruit donors who are more likely to be matches for patients both in India and around the world.
Cord blood: an important transplant option
In 2008 we opened the UK’s first dedicated cord blood bank to store donated umbilical cord blood, which can be a source of stem cells for a transplant. Cord blood requires less stringent genetic matching and can offer patients without a full match another option for transplant.
Since then, we’ve facilitated over 400 cord blood transplants around the world. Cord blood provision is a vital part of our commitment to provide more treatment options to patients with less common tissue types.
Learn more about cord blood’s crucial role in stem cell transplants.
More donor options through a new treatment, PTCy
One major area of global 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.
We don’t currently perform research on the use of PTCy ourselves, but research from the US has shown that PTCy can give patients with a mismatched donor the same chance of surviving as patients with a well-matched donor.
Several transplant centres in the UK have started using PTCy in specific cases, but there is more work to do to understand how to safely and effectively introduce it more widely across the UK. Through the clinical trial organisation IMPACT, we are supporting a first-of-its-kind trial into PTCy for UK patients. If results are promising, this could drastically widen the available donor pool for patients with rarer tissue types, so could make a huge impact on healthcare inequities.
New cell therapies
New cell therapies have the potential to reduce the need for full tissue type matching, helping to address inequities for those less likely to find a match, or even the need for a stem cell transplant at all.
CAR T-cell therapy – using the patient's own cells
Some cell therapies, including CAR T-cell therapy, involve genetically modifying the patient’s own cells to treat the underlying cause of disease. This avoids the need to find healthy cells from a matched unrelated donor.
We are campaigning about the need for wider access to new and emerging cell and gene therapies, like CAR-T, especially for patients from minority ethnic backgrounds who may have more limited treatment options. We’ve carried out research identifying inequities in cell therapy access across the UK, which is informing our future policy and influencing work.
Natural killer cells – cell therapies without genetic matching
We also conduct our own research into cell therapies that could provide new hope to patients with fewer treatment options. One particular avenue of research focuses on natural killer (NK) cells – a type of immune cell that can fight cancer – and how we can use them to treat blood cancer relapse, or as a supportive therapy alongside stem cell transplants.
An advantage of NK cells is they don’t require genetic matching to the patient, meaning they could help any patient, regardless of their tissue type. This could be especially useful for patients from minority ethnic backgrounds who are more likely to have a rare tissue type on UK registers.
Mesenchymal stromal cells – treating GvHD with cells
Another area of our research is looking at mesenchymal stromal cells (MSCs). MSCs are a type of stem cell that have anti-inflammatory properties, meaning they could potentially be used to combat the inflammatory effects of GvHD. This could help address healthcare inequities by improving transplant outcomes in patients with less well-matched donors, who are at a greater risk of developing GvHD.
Learn more about our work on NK cells and MSCs on our Immunotherapy group page.
Post-transplant recovery
We know a transplant doesn’t end on the transplant day, and patients can experience months or even years of recovery which can dramatically impact their quality of life.
But not all patients start on the same footing for their recovery. Financial status, caregiving responsibilities, or even location in the country can all influence the types of support and follow-up care available to patients.
Our SEQoL study (which stands for Scaled collection of socioEconomic and Quality of Life data) is a landmark UK project, aiming to better understand the impact of a transplant on patients’ wellbeing and quality of life. It is collecting patient experiences like those mentioned above to give us a more complete picture of how a transplant can affect all areas of life and wellbeing during recovery.
SEQoL will evaluate if socioeconomic factors or ethnicity can be connected to changes in quality of life after a transplant. This could help identify areas of transplant care that must be improved to address inequities.
What the future holds
Our goal is a future where every patient who needs a stem cell transplant can survive and thrive. This means we will continue to be dedicated to researching the causes of inequities in stem cell transplants and the reasons behind some transplants not succeeding.
Our lifesaving research is only possible thanks to people who support our work. Find out how you can make a difference.