A Fair Chance: Second Stem Cell Transplant Campaign
What is the Second Transplant Campaign?
DKMS UK, Leukaemia UK, and Anthony Nolan have launched a joint campaign calling for a formal review of the NHS England’s 2017 policy on second allogeneic stem cell transplants for patients following relapse.
The three charities are urging for reform so that no patient is denied a potentially lifesaving stem cell transplant just because they cannot afford it.
What's the current situation in England?
Access to a second stem cell transplant is currently subject to strict criteria. Patients must be in complete remission, clinically fit enough to undergo treatment, and have relapsed more than 12 months after their first transplant.
However, patients who relapse within 12 months are automatically excluded. This creates a hard cut-off in an area of medicine where decision-making is rarely straightforward, excluding people whose specialist team believes that a second transplant may be their only curative option.
Why might someone need a second stem cell transplant?
For some people with blood cancer, the disease returns after their first transplant. Depending on the type of cancer, how it responds to further treatment, and the patient’s overall health, a second transplant may offer another opportunity to achieve long-term remission or cure.
It's not suitable for everyone, but for some patients – like Ruth, Faith, and Sean – it may be one of the few remaining treatments with curative potential.
For them, this policy is not just unfair, it's life threatening.
But together, we can change that.
Our support can help give people every chance at life possible.
What are we calling for?
The joint campaign is therefore not asking for every patient to receive a second transplant.
A second transplant is a major and potentially dangerous treatment, and it will not be appropriate for every patient.
The campaign is asking just for NHS England to review the evidence and replace the rigid 12-month rule with a transparent, risk-stratified process through which specialist teams can consider the whole patient.
A fair chance
Together with Leukaemia UK and Anthony Nolan, we are calling on NHS England to urgently review this policy and move towards a fairer, risk-stratified approach for patients who may have no other curative option.
But we cannot do this alone.
For every patient to have a fair chance, we need to your help by signing the Parliamentary Petition.
When Ruth, 58, from Staffordshire was diagnosed with acute myeloid leukaemia in January 2024, she underwent four rounds of chemotherapy, before receiving a stem cell transplant later that year. Unfortunately, she relapsed nine months later, and was shocked to learn that under NHS guidelines, she would not be eligible for a second transplant.
Ruth was told that once her temporary treatment stopped working, she would go into palliative care, despite her clinicians believing a second transplant was worth pursuing.
It soon became clear that there were no exceptions and no appeal process.
Refusing to give up, she contacted her local MP with the request to raise the issue in Parliament, and began talks with charities, including Leukaemia UK.
Thankfully, Ruth was able to secure funding from her company's medical insurance to pay for a second transplant privately and is currently recovering, but her experience has highlighted the need for an urgent review of the policy which threatens the lives of those who cannot afford to pay for a second transplant themselves.
For Faith Hinitt, a 27 year old from Nottinghamshire, a second stem cell transplant wasn't just an option, it was her only chance at survival.
After being diagnosed with acute myeloid leukaemia in 2023, she unfortunately relapsed within twelve months of receiving her transplant. While a second transplant would give her the chance of a healthy future, she was told the NHS would be unable to fund it.
Faith had to create a GoFundMe page to raise over £100,000, so that her treatment could go ahead. Thankfully, she reached the target, and received her stem cell transplant in July, but for many others in her position, this simply wouldn't be possible.
Sean, 40, was diagnosed with AML in 2024. After his transplant relapsed, the NHS told him no further treatment options were available to him in the UK. Like Ruth, Sean too had to rely on crowdfunding, alongside substantial loans taken out by friends and family members, to access a second transplant in Germany.
"I’m a young man with a wife and two-year-old boy at home, and just want the chance to keep fighting, to be there for him", Sean explains. "I want to watch my son grow and make memories as a family."
"The NHS left me feeling like I had no choice but to look elsewhere, like my life didn’t matter. I was being denied a second chance. Even when saying I would do what it takes by self funding."
Sean's family had no choice but to seek treatment abroad, but with that, came the added worry and stress of treatment and aftercare in a foreign country. "It's placed an enormous amount of emotional, physical, and financial strain on all of us - my wife still working and caring for our son while I try and recover hundreds of miles away. No family should have to go through this."
All three patients have now received a second stem-cell transplant and are currently recovering, but these examples expose the inequality gap being created by the current system.
No patient should be forced into private healthcare, debt, or crowdfunding to access the only treatment that could give them a chance of survival.
We must ensure patients all have a fair chance and do not fall through the cracks in our healthcare system.
What is the existing policy based on?
The current policy, first agreed in 2017, was based on an evidence review completed in 2015. That evidence was mainly retrospective, heterogeneous, and often drawn from small or historic cohorts.
However, over the past decade, stem cell transplantation has evolved significantly. Advances in donor matching, conditioning regimens, and infection management have all improved outcomes and expanded the range of patients who clinicians believe should be considered for treatment. Crucially, this is not always patients who have reached the 12-month threshold.
How do other countries approach these decisions?
This is no single international rule, but when it comes to comparisons across international healthcare systems, the UK is significantly out of step. Decisions abroad about second transplants are often based on a patient’s full, considered clinical picture and not an arbitrary time threshold.
As well as this, many other countries including Germany, Sweden, Australia, and Canada use far more updated data to inform decisions around second transplants, and France has changed the threshold of eligibly to six months after a first transplant.
Collectively, these developments suggest that the current NHS England policy is outdated, and it is patients like Ruth who are paying the price.
Sign the petition today
No policy can guarantee a cure, but it should never prevent patients from being considered for treatment that could save their life.
Every patient deserves the chance to be assessed fairly, and every clinician should have the ability to make evidence-based decisions based on the full picture of a patient's health, disease and prospects, not an arbitrary timeframe.
It is time for NHS policy to catch up with modern clinical practice.
Share your own story
If you or your family have been affected by this policy and are interested in sharing your story, please get in touch with us using the form below.
Voicing your experience can help remind other people out there that they are not alone.
Share your experienceThe policy currently published by NHS England, reference 16068/P, says that a second transplant following relapse will be routinely funded only where:
- the patient is in complete remission;
- the disease returned more than 12 months after the first transplant; and
- the patient is clinically fit enough to undergo the treatment, as determined by a multidisciplinary team.
The policy states patients whose disease returns within 12 months should not be considered for a routinely commissioned second transplant, and also goes on to say that a further allogeneic transplant should not be offered if a patient relapses following their second transplant.
It applies to patients in England.
The timing of relapse is clinically important. In general, patients whose disease returns earlier have poorer outcomes than those whose disease returns later. The concern is not that timing should be ignored, but that the policy turns one prognostic factor into an automatic pass-or-fail rule.
Modern evidence shows that a patient’s prospects are affected by several connected factors, including disease status, response to treatment, performance status, other health conditions, previous transplant complications and the timing of relapse. The evidence does not establish that 12 months is a validated universal point below which no patient could benefit. Several modern studies instead identify relapse within the first six months as a particularly adverse factor and support assessing risk across a range of clinical characteristics.
Each devolved nation will approach guidance slightly differently.
Patients should first ask their transplant team to explain whether the decision is based on clinical judgement, their NHS commissioning criteria, or both.
In Scotland, there is more flexibility in timeframe between relapse and a patient’s first stem cell transplant. The clinician will then make the decision if a second stem cell transplant is right for them.
In Wales, the guidance aligns closely with NHS England’s policy. There may be an opportunity to submit an individual patient funding request. This must be submitted by a clinician where a patient and NHS clinician have agreed that they would be suitable for treatment, but is not eligible in line with the clinical policy criteria.
Patients should continue to make treatment decisions with their specialist clinical team and should not delay urgent care while pursuing a funding request.
The most important action is to sign the petition and share it with others who may support a fairer approach to second transplant decisions. Fund second stem cell transplants on NHS for relapse within 12 months - Petitions
UK Parliament petitions that receive 10,000 signatures receive a Government response. Petitions that reach 100,000 signatures are considered for debate in Parliament, although a debate is not automatic.
Supporters can also share the campaign’s patient stories and social media posts.