Three of the country's leading blood cancer charities have launched a joint campaign urging NHS England to abandon a commissioning rule that automatically denies funding for second stem cell transplants to patients who relapse within a year of their first procedure. Anthony Nolan, DKMS UK and Leukaemia UK are calling the policy outdated and unfair, and want it changed to reflect modern practice and clinical opinion.

A second stem cell transplant can give patients another chance of survival if their blood cancer returns after an initial procedure. Under NHS England's commissioning policy, which covers donor transplants and was introduced in 2017, the health service will not fund a second transplant for anyone who relapses within 12 months of their first, regardless of their individual circumstances. That leaves some patients with limited options.

The consequences for those affected can be severe. Patients left in this position face palliative care or the prospect of funding treatment privately, according to the charities. One case highlighted by the campaign involves a man from Runcorn who travelled to Germany for a stem cell transplant after being refused one on the NHS, at considerable personal cost. Another campaigner, a 28 year old woman from Retford, was diagnosed with acute myeloid leukaemia and received her first transplant from her brother in September 2024, only to be told she was not eligible for another after her cancer returned. She has described the experience as leaving her family in desperation, adding that ordinary families do not have hundreds of thousands of pounds spare for treatment abroad.

Campaigners are not asking for automatic access to second transplants. They want an end to automatic exclusion, replacing the fixed cut-off with a transparent, risk-stratified process based on evidence, clinical need and expert judgement rather than a rigid deadline or a family's ability to pay. Michael Gallagher, policy and public affairs manager at DKMS UK, put it plainly. "Timing of relapse matters, but it should inform a clinical decision, not dictate it," he said.

Doctors and charities argue that the science has moved on since the rule was drawn up nearly a decade ago. Yasmin Sheikh, head of policy and public affairs at Anthony Nolan, said transplant medicine has advanced significantly in recent years and that clinicians should be able to base decisions on the latest evidence and what suits each individual patient.

Other countries already take this approach. Germany assesses eligibility for a second transplant case by case, rather than applying a set timeframe since the first procedure, putting NHS England's approach out of step with much of Europe.

The scale of the issue is small in absolute numbers but significant for those affected. Figures cited by Leukaemia UK, drawn from NHS England data used to inform the original policy, found that 184 patients underwent a second donor transplant for relapsed disease over a ten year period between 2000 and 2009, mostly for acute myeloid leukaemia, chronic myeloid leukaemia, lymphoma, myeloma and myelodysplastic syndromes. Around 123 of those patients, roughly 12 a year, had remained in remission for more than 12 months before relapsing and going on to a second transplant. The rule under scrutiny affects those who relapse earlier than that.

Georgia Papacleovoulou, head of policy and advocacy at Leukaemia UK, said the treatment can represent a patient's only realistic chance. "Treatment decisions should be based on clinical need and no patient should have to turn to private healthcare or fundraising for a life-saving treatment," she said, adding that the policy needed updating so all patients could access the care they need.

As part of the campaign, the charities have launched a petition calling on NHS England to review and update the policy, and are encouraging members of the public to add their names.

NHS England has responded to the pressure by opening a formal review. The health service confirmed it has commissioned an independent evidence review into the case for a second allogeneic stem cell transplant. No timeline has yet been given for when that review will report or what changes, if any, might follow. For now, the 12-month rule remains in place, and patients whose cancer returns early continue to face the same restricted choices that prompted the campaign.

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