Black and Asian cancer patients are less likely to survive in the five years after a donor stem cell transplant than their white counterparts, according to a study and largest of its kind.
The study, published in Lancet Haematology, looked at 30,000 patients who had a stem cell transplant between 2009 and 2020 on the NHS, with 19,000 of these being cancer patients.
The research found that cancer patients from every minority ethnic background had an increased risk of fatal complications after a donor stem cell transplant in comparison with their white counterparts. There was a higher risk of death in the 100 days after the transplant for black and Asian patients compared with white patients.
Black and Asian patients also had a lower rate of survival after the treatment, with adult patients being 1.5 times more likely to die within five years after a donor transplant in comparison to their white counterparts.
The study also found that Asian children had a 32% risk of death within five years of a donor transplant, compared with white children who had a 15% risk.
Stem cell transplants are an important form of potentially life-saving treatment for thousands of patients who are experiencing blood cancer or a serious blood disorder. The transplant works by replacing a patient’s unhealthy blood stem cells with new cells from either the patient or a genetically matched donor.
The study is believed to be the largest of its kind to look at the impact of ethnicity on stem cell transplant outcomes in the UK by its researchers. Previous research has shown that ethnic minority patients have only a 37% chance of finding a well-matched stem cell donor, compared with white patients having a 72% chance.
The researchers added that more research was needed to look at the cause of this ethnic disparity.
Dr Neema Mayor, the director of immunogenetics and research services at Anthony Nolan and the lead author of the study, said the research revealed for this first time that “ethnicity affects survival following a stem cell transplant”.
Mayor says: “Despite stem cell transplants having been used as a treatment for blood cancer and blood disorders for over 50 years, until now there was little known about the health inequalities experienced by patients in the UK.
“While our analysis cannot explain why we see this difference between people of different ethnicities, we know there are likely to be complex genetic, socioeconomic and systemic factors which intersect with ethnicity to affect patients’ outcomes.
“Our research is actively investigating the impact of many of these factors, so we can continue to work to ensure all patients have equal access to, experience of and outcomes from a stem cell transplant.”
Prof John Snowden, a consultant haematologist from the British Society of Blood and Marrow Transplantation and Cellular Therapy, said: “The study has identified significant health inequalities that require further investigation, explanation and ultimately correction so that the same chances of life-saving transplant treatment can be offered to all patients irrespective of ethnicity and heritage.”
