Our research donors
A hugely important part of Anthony Nolan’s work is our provision of stem cells to researchers from hospitals, universities, and pharmaceutical companies, which contributes to the development of groundbreaking new treatments for patients. This wouldn’t be possible without our amazing research donors, who willingly provide their stem cells for medical research and treatments that could go on to help countless patients.
With the astounding growth of cell and gene therapies in recent years, there is a greater than ever demand for human blood stem cells to help develop new treatments for patients; especially for blood cancers and blood disorders.
Our priorities are always to patients and donors – so we want to ensure that our incredible research donors are fully supported and their donations will make the biggest impact possible for patients.
Part of our work in this area is pioneered by Salmah Ahmed, our director of quality & regulation, and chair of the Cell and Gene Therapy Committee at the World Marrow Donor Association (WMDA). As part of her work with the WMDA, Salmah recently co-authored a paper on the best strategies to ensure the wellbeing of donors and patients in the area of donations for medical research and treatments.
One of the most important issues in donor wellbeing is the question of remuneration – should we be paying donors for their cells?
In the UK, it’s illegal to provide direct payment for human tissues and cells. However, the law varies in other countries, and some places (including about a dozen US states) allow for payment of donors for their stem cells.
There are many ethical arguments against paying donors for their cells, some of which we’ll outline here.
The risks of remuneration for stem cell donations
Donors Taking Greater Risks. Although donating cells through peripheral blood stem cell (PBSC) collection is relatively safe, there are still risks associated with it, which donors are made fully aware of. If there is monetary incentive offered, some donors may then weigh the risks against the financial benefit, potentially causing donors to take greater risks than they would otherwise. This problem would become compounded if companies offered greater financial incentive for riskier donation methods. This muddies the waters of consent for donations, which must be free from external pressures to adequately weigh up the personal risks.
More Repeat Donations. Research donors may be incentivised to repeatedly donate if there is a financial incentive. Uniquely compared to blood donations, the more donations a stem cell donor provides, the higher the risk there is of negative health effects. This is why most donor registries set a limit on the number of times and the regularity that donors may donate. With monetary incentive, some donors may wish to circumvent these limits, and organisations may remove them in order to attract more donations.
Harm to Patients. If research donors are offered financial incentive, this also provides an incentive for donors to lie about their medical histories or withhold information in order to guarantee a donation being accepted. This could result in issues with the quality of donated cells, potentially hindering research or even leading to direct patient harm if cells are directly used in clinical trials.
Targeting Vulnerable People. Offering a financial incentive for donations could target vulnerable groups who have greater rates of poverty, who already suffer increased exploitation and may face an unfair burden of risk by being disproportionately recruited for donations.
Putting a Price on our Bodies. Paying for cells also places a price on the human body, which threatens to erode the altruism at the heart of cell donations that have patient benefit. This price may also change depending on the organisation or donation method, and companies may perpetuate existing inequalities or prejudices by valuing individuals differently.
Commodification. Monetising the donation of cells could lead to the commodification of certain types of cells, or cells from people of particular tissue types or ethnicities. This could create a ‘market’ for donors which devalues the dignity of donors and harms the altruistic nature of donation.
Our stance
Anthony Nolan adheres to UK law, and also agrees with the WMDA guidance that non-remuneration (not paying for their cells) is the best way to protect the safety of donors and patients. Although some may worry that donors aren’t as enthusiastic about research donation compared to donation for transplant, our data suggest otherwise – 87% of people surveyed on our register are willing to donate for research. Therefore, remuneration not only comes with a long list of risks; it’s also not necessary to incentivise research donation in this way.
Anthony Nolan covers all incurred expenses due to the donation procedure, as we do for transplant donations, so donors have no out of pocket expenses. Donation is an act of selflessness that should not harm or hinder the donor, while also having immeasurable benefit for future patients.
We are dedicated to maintaining the safety of donors and patients, including keeping in place various welfare checks and measures for donors such as limits to repeat donations and full medical screening. We review these measures regularly, and we welcome feedback from research donors and the patients that this research supports. A survey of our register and the public has shown that potential donors desire full transparency and open communication about the use of donated cells in research.
Our Cell Collection Centre
Our recently announced Cell Collection Centre will grant us more control over the collection of cells from donors for both transplant and medical research. This will help us monitor and manage donor wellbeing more effectively than would be possible at third party facilities.
We will be running our own research studies at the facility with the aim of improving our collection methods and enhancing donor wellbeing, which could also potentially improve the quality of cells for both transplant patients and for medical research.
Read more about our Cell Collection Centre here.
Join us
If you’re interested in donating your cells for medical research and treatments, sign up to our register here and then contact our research donor team: researchdonors@anthonynolan.org
If you’re a researcher or industry professional looking for expert advice or bespoke cellular materials, learn more about working with us here.
Read the research in full
This article is mainly based on research co-authored by Salmah Ahmed, our director of quality & regulation:
Hamad L, Ahmed SM, van Eerden E, van Walraven SM; World Marrow Donor Association Cellular Therapy Committee; Machin L. Remuneration of donors for cell and gene therapies: an update on the principles and perspective of the World Marrow Donor Association. Bone Marrow Transplant. 2024 May;59(5):580-586. doi: 10.1038/s41409-024-02246-x.
We also mention research co-authored by other Anthony Nolan colleagues:
Hamad, L., Anthias, C., Gibson, D., O’Leary, A., & Machin, L. (2023). Prospective Donors’ Perspectives on Hematopoietic Cell Donation for Cell and Gene Therapy Research and Development. Regenerative Medicine, 18(4), 301–311. https://doi.org/10.2217/rme-2022-0195.
Hamad, L., Chekar, C. K., Anthias, C., & Machin, L. (2024). Facilitating the ethical sourcing of donor hematopoietic stem cells for cell and gene therapy research and development. Regenerative Medicine, 19(6), 317–326. https://doi.org/10.1080/17460751.2024.2357930