UK stem cell transplant charity Anthony Nolan, in collaboration with India's largest stem cell register DATRI, has carried out a major recruitment drive to address the global shortage of stem cell donors for patients of South Asian heritage.
A stem cell transplant is a potentially curative treatment for blood cancers and blood disorders.
Patients from minority ethnic backgrounds in the UK are more likely to have a rare tissue type on the UK register, making them less likely to find an unrelated stem cell donor compared to those with white or northern European heritage.
In an innovative three-year pilot project, funded by the National Institute for Health and Care Research (NIHR), Anthony Nolan and DATRI recruited an additional 10,000 Indian donors who could go on to donate to British Asian patients, as well as patients in India or elsewhere in the world.
Anthony Nolan researchers used data-driven approaches to target recruitment to specific areas which could go on to help British Asian patients.
Northwestern regions of India, including Rajasthan and Gujarat, were found to have the highest concentration of potential donors with tissue types similar to those most needed by UK patients. Previous recruitment by DATRI had concentrated in Southern regions.
Although the recruitment drive was collaboratively designed with British Asian patients in mind, diversifying the global stem cell register has significant benefits for South Asian patients around the world. So far, ten donors recruited through the project have gone on to donate to a patient in need of a stem cell transplant in India.
Analysis of the newly recruited donors showed 8 out of 10 had tissue types that are not currently represented on the Anthony Nolan register. UK patients in need of a match who searched the DATRI register were 6-7 times more likely to have a 10/10 match among the new donors compared to the rest of the DATRI register.
Patients are more likely to find a successful match from someone of a similar heritage, however the global stem cell register is not currently reflective of the world’s population. Two-thirds of registered donors worldwide are from Europe and North America and just 16 per cent of potential donors across the aligned UK registry are from a minority ethnic background.
Research from Anthony Nolan shows Asian patients in the UK have poorer survival rates compared to white patients following a stem cell transplant, with Asian cancer patients 1.5 times more likely to die from complications within five years of a donor transplant compared to white patients.
As well as working to increase the diversity of the stem cell register, Anthony Nolan is also carrying out research to improve survival rates and understand and address long-standing health inequities.
Dr James Robinson, director of bioinformatics at Anthony Nolan and leader of the study said:
An under representation of South Asian donors and long-standing health inequities mean this group are more likely to face challenges in finding a matching stem cell donor and experience worse survival after a transplant.
Our research shows that targeted, evidence-based recruitment and international collaboration can help diversify the global pool of stem cell donors and improve the chances of patients finding a matching donor.
The British Asian population is the largest minority ethnic group in the UK, making this collaboration with DATRI a natural first step to investigate the use of data-driven recruitment to reduce inequities. In future, this approach could be used to recruit more donors from India or other underrepresented regions, with the potential to save countless lives.
Yasmin Sheikh, head of policy and publics affairs at Anthony Nolan, said:
Finding matching donors is a critical challenge in stem cell transplantation, particularly for patients from a minority ethnic background who are more likely to have a rare tissue type. Innovative international collaborations like this one are helping to shift the needle on long-standing health inequities and improve the odds of more patients finding an unrelated matched stem cell donor.
But addressing inequities must go beyond diversifying the stem cell register. That’s why our researchers are investigating new treatment approaches and working to better understand the causes behind patient inequalities.
Claudia Rutt, CFO at DATRI Blood Stem Cell Donors Registry, said:
Every donor on a registry represents a possibility for a patient waiting for a lifesaving match. India’s vast and diverse population, together with its millions of people living around the world, makes building a representative donor pool both essential and challenging. Technology and data have helped us to identify where donor recruitment can have the greatest impact and reach communities that are underrepresented in the global donor pool.
With Anthony Nolan’s research expertise and support, and funding from the NIHR, we have recruited 10,000 additional Indian donors, strengthening the diversity of the Indian-origin donor pool. What makes this achievement particularly meaningful is that donors recruited through this initiative have already given 10 patients a second chance at life. We hope this is just the beginning, and that many more patients in India, the UK and around the world will have the chance to find their lifesaving match.
Pradeep Thatai, 75, from Kent, was diagnosed with acute myeloid leukaemia following a routine blood test and bone marrow biopsies. He underwent intense chemotherapy and was told that his best chance of a cure was a stem cell transplant, which he received from an Indian donor in July 2022. Pradeep said:
I was told that because I’m from Indian heritage, it might take longer for me to find a donor. I was expecting it to take months or even years, but within a few weeks I was told there was a 100% match for me – a donor based in India.
It’s now been four years since my transplant and I’m in full remission. I feel so grateful to my donor. He lives on the other side of the world to me, but if it wasn’t for him, I wouldn’t be here today.
It’s amazing that this project has recruited an additional 10,000 Indian donors. I remember how scary it was waiting for a donor – projects like this could go on to save the lives of people like me anywhere around the world.
This project is funded by the NIHR. The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care.