Expanding Patient ACCESS With Mismatch Transplant Donors

In an interview, Antonio Jimenez Jimenez, MD, discusses the rationale behind the ACCESS study, an initiative seeking to improve patient access to and outcomes from stem cell transplants using mismatch unrelated donors.

The ASTCT-NMDP ACCESS Initiative is a collaborative effort by the National Marrow Donor Program (NMDP) and the American Society for Transplantation and Cellular Therapy (ASTCT) to combat inequities in patient access and outcomes for blood stem cell transplants and cell therapies.

Launched in 2022, the initiative aims to dismantle barriers to treatment by focusing on policy and clinical practice changes. Key areas of focus include:

• Increasing Awareness: This involves educating medical professionals, patients, caregivers, and potential donors about transplant and cell therapy options. Initiatives include developing educational resources, fostering collaboration between physicians through programs like the Regional Physician Exchange, and improving data collection to understand health equity needs.
• Facilitating Economic Empowerment: The initiative seeks to identify and support patients facing financial hurdles, such as insufficient insurance coverage, that can lead to poorer outcomes. A significant effort in this area is addressing gaps in Medicaid coverage for these life-saving treatments, including developing clinical guidelines for state Medicaid offices and advocating for improved coverage.

The ACCESS Initiative emphasizes the importance of broad stakeholder involvement from clinicians, institutions, policymakers, researchers, and payer organizations to achieve sustained, meaningful change and ensure all patients have access to treatment regardless of their background or financial situation.

As Jimenez Jimenez explains, the rationale behind ACCESS was twofold.

"We know that for Caucasian patients, the likelihood of finding a donor 8/8 in the registry is close to 80%, but that's 50% for a Hispanic patient, around 20% to 30% for an African-American patient. So the idea was to in an effort to expand transplant access, but also improve the outcomes of mismatch transplantation," Jimenez Jimenez said in the interview.

REFERENCE:

ACCESS Initiative targets inequities in cell therapy. NMDP. Accessed July 7, 2025. https://tinyurl.com/4bk6a3y7