Improving Global Access to Transplantation: A Decade of the DKMS ATT Program
Our mission is to give as many patients with blood cancer or blood disorders as possible a second chance at life. For many, a hematopoietic stem cell transplantation (HSCT) is the only chance for a cure. Access to HSCT is unevenly distributed around the world, largely due to socio-economic factors. The recently published article in Blood Global Hematology, which can be accessed fully here, describes our goal to improve equitable access to HSCT globally.
To generate the greatest possible impact, we focus our ATT activities in regions with a beneficial cost-benefit ratio, namely in low- and middle-income countries (LMICs) such as India. We concentrate our efforts on transplantations in pediatric patients with severe thalassemia (ST) or sickle cell disease (SCD), as these procedures are relatively straightforward, have high success rates, and offer a substantial number of potential life years gained per patient.
Three ATT pillars
With its three ATT pillars - free HLA Typing, Patient Funding, and Capacity Building - we significantly reduce barriers to lifesaving transplantation in LMICs:
Free HLA Typing
Free HLA Typing can be offered to patients and their core families thanks to the cost-efficient, ultra-high throughput workflow of our DKMS Life Science Lab. Finding a genetic match often represents the first step and motivation for many families to begin securing funding for a potential transplant. Through this pillar alone, our lab has completed over 53,000 analyses, resulting in more than 1,600 transplantations so far. A large part of the HLA Typing is the result of our DKMS Thalassemia Program organized by our DKMS Foundation India together with local partners.
Patient Funding
Within the Patient Funding pillar, we contribute to covering the costs of a HSCT. That is particularly important as in many countries, especially in LMICs, HSCT costs are not or not fully covered by the public healthcare system. Many patients are not able to afford the costs in full themselves. To date, we have supported 949 transplantations of patients in LMICs with a mean funding amount of USD 5,340 which represented 36% of the total transplant costs on average in India.
Capacity Building
While the first two pillars of ATT address individual financial and logistic barriers, the third pillar, Capacity Building, focuses on expanding limited transplant infrastructure. This includes investing in medical facilities and training specialized personnel. We have funded 32 BMT rooms, provided advanced training for nurses, awarded scholarships for physicians, nurses, and laboratory staff, and supported scientific programs. One central program is our BMT Start-Up Program for non-profit or public hospitals that aim to offer curative bone marrow transplantation for ST or SCD patients with matched sibling donors. We provide free HLA Typing and expert guidance from experienced transplant specialists. The goal is to establish sustainable patient care by enabling partners to provide safe, effective, and low-risk HSCT, and we invite eligible hospitals to apply. Further details about the program and the application process are available here.
Local partnerships
Across all ATT pillars, we work closely with local partners, such as Sankalp Foundation in India. These partners know the respective area and help ensure that resources are applied efficiently. This is especially relevant in the Capacity Building pillar, where knowledge of the local infrastructure is crucial.
Throughout all activities, we adhere to clear ethical principles. Since not every patient can be supported, transparent selection criteria are essential. Discrimination based on gender, ethnicity, religion, caste, or any other factor is strictly excluded. We only establish partnerships with organizations that uphold these standards and share our commitment to equitable access.
Outlook
The current focus of our ATT activities is India, where we already operate a donor center and where hemoglobinopathies are highly prevalent. However, our ATT programs have also been implemented in Armenia, Uzbekistan, Vietnam, Pakistan, South Africa or Chile, and other countries. Looking ahead, we aim to further expand our impact in India and strengthen our efforts in regions with high hemoglobinopathy burdens but low transplantation activity, such as parts of Sub-Saharan Africa.
Over its first decade, our ATT program has demonstrated how targeted, collaborative, and ethically guided support can help patients in disadvantaged regions to receive a lifesaving HSCT. We plan to build on past achievements and further improve equitable access to HSCT in the coming years.
Reference:
1. Landwehr, R. et al. Blood Global Hematology 2026; 2 (2): 100067. https://doi.org/10.1016/j.bglo.2026.100067