NHS urged to scrap ‘outdated’ transplant rule

NHS England is being urged to review an “outdated” rule which can prevent blood cancer patients from receiving a second potentially lifesaving stem cell transplant.

Blood cancer charities Anthony Nolan, Leukaemia UK and DKMS UK have joined forces to call for a review of the policy, which can exclude patients from receiving a second transplant on the NHS if their cancer returns within 12 months of their first.

Under current NHS England criteria, patients being considered for a second allogeneic stem cell transplant must be in complete remission, be clinically fit enough to undergo the procedure and have relapsed more than 12 months after their first transplant.

Those whose cancer returns within 12 months are automatically excluded, even in cases where their specialist clinical team believes another transplant could offer a chance of long-term remission or cure.

The charities argue the rigid cut-off fails to reflect advances in blood cancer treatment and does not allow doctors to adequately consider the individual circumstances of patients.

Their new A Fair Chance campaign is calling for NHS England to formally review the policy and replace the 12-month cut-off with a transparent, risk-based assessment that allows specialist teams to consider each patient individually.

The organisations stressed they are not calling for every patient whose cancer returns to automatically receive another transplant.

Second stem cell transplants carry significant risks and are not suitable for everyone, but the charities say decisions should be based on clinical evidence and individual circumstances rather than an automatic time limit.

The campaign has been backed by patients including Faith Hinitt, from Retford in Nottinghamshire, who was diagnosed with acute myeloid leukaemia in 2023.

She received her first stem cell transplant through the NHS but was refused a second after her cancer returned within a year.

The 28-year-old subsequently had to raise more than £100,000 to fund treatment privately.

Her second transplant was successful and she is now supporting calls for other patients to be given the opportunity to have their cases considered individually.

The charities warn the current system risks creating inequality because patients who are refused NHS treatment may only be able to access another transplant if they can raise substantial sums privately.

NHS England has confirmed that it has commissioned an independent review of the evidence surrounding second allogeneic stem cell transplants.

The campaign organisations say the review represents an important opportunity to modernise the policy and ensure future decisions reflect current clinical evidence.

They are calling for a system which allows specialist medical teams to consider factors including a patient’s overall health, type of blood cancer, response to treatment and individual likelihood of benefiting from another transplant.

The charities say no patient should be denied a potentially curative treatment simply because they fall on the wrong side of a fixed 12-month cut-off.

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