Blood cancer charities are calling for an urgent review of an NHS England policy that can prevent some patients from accessing a second potentially life-saving stem cell transplant.
For people living with blood cancer, a stem cell transplant can represent a chance of remission, recovery and more time with the people they love.
But what happens when the cancer returns?
For some patients, a second stem cell transplant may offer another opportunity for long-term survival. Yet campaigners say that an NHS England policy introduced in 2017 can automatically exclude some patients from receiving a second transplant based on when their disease returns.
Under the current policy, patients whose blood cancer relapses within 12 months of their first stem cell transplant can be ruled out from receiving another transplant through NHS-funded treatment.
Three leading blood cancer charities – Anthony Nolan, DKMS UK and Leukaemia UK are calling for this approach to change.
When a fixed rule can affect a second chance
A stem cell transplant is a complex and intensive treatment. It is not suitable for every patient, and decisions about transplantation must take into account factors including a person’s health, disease status, previous treatment and the potential risks and benefits.
The concern raised by campaigners is not that every patient should automatically receive a second transplant.
Instead, they argue that a fixed 12-month cut-off should not automatically determine whether a patient can be considered for potentially life-saving treatment.
Medical knowledge and transplant practice have developed significantly since the policy was introduced. Campaigners say decisions should reflect current evidence and the circumstances of each individual patient.
Leukaemia UK describes the existing approach as a rigid “12-month rule” and says that treatment outcomes and approaches have changed over the past decade.
Why does timing matter?
When blood cancer returns after a transplant, doctors may consider a range of treatment options.
For some patients, a second allogeneic stem cell transplant, using blood-forming stem cells from a donor may be considered.
However, the treatment carries significant risks and is not appropriate for everyone. The question being raised by campaigners is whether the 12-month threshold should be used as an automatic exclusion, rather than allowing specialist clinicians to assess each patient’s circumstances.
DKMS UK says the current policy can rule patients out when they relapse within 12 months of their first transplant, even where further treatment may be considered.
This is particularly important because blood cancers are not identical in every patient. Disease biology, response to treatment, overall health and available treatment options can all influence whether another transplant might be appropriate.
A call for personalised decision-making
Anthony Nolan, DKMS UK and Leukaemia UK are calling on NHS England to update its policy.
Their position is clear: this is not a call for automatic second transplants for everyone.
It is a call for patients to be assessed individually, using contemporary clinical evidence and specialist medical judgement.
That distinction matters.
A second transplant is a serious procedure with potentially significant complications. The decision must remain a clinical one, made between patients and their specialist healthcare teams.
But campaigners believe that a patient should not be automatically ruled out simply because their disease returned before an arbitrary time threshold.
Anthony Nolan has described the current policy as “outdated and unfair” and is calling for the fixed 12-month cut-off to be reviewed.
The question now is whether NHS policy should allow that possibility to be considered on the basis of individual clinical circumstances rather than a fixed 12-month rule.
As the campaign for change continues, patients, families and the wider blood cancer community will be watching closely.
Everyone facing blood cancer deserves access to treatment decisions that are fair, evidence-based and centred on their individual circumstances.
Our message
We are proud to support the campaign calling on NHS England to update its policy on second stem cell transplants and we stand alongside Leukaemia UK, Anthony Nolan and DKMS UK.
Please sign, share with friends, family and your networks, and lets give every patient a fair chance.
Sign here: https://petition.parliament.uk/petitions/777325
