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Around 5,000 blood cancer patients could benefit from 13 treatments recommended by NICE in 2024.

This is the largest number of positive recommendations in a single year for blood cancer treatments. NICE has made almost 100 positive blood cancer treatment recommendations in the last decade.

Blood cancer is the third biggest cancer killer in the UK after lung and bowel cancer. It covers many different cancers, including: lymphoma which affects lymphocytes (white blood cells in the lymphatic system), leukaemia which impacts blood cells in the bone marrow, and myeloma which affects plasma cells (a type of white blood cell). Within these categories there are often subtypes such as Hodgkin and non-Hodgkin lymphoma.

Rosie Dill's story highlights treatment progress. On initial diagnosis in 2012, she had limited options, but she now benefits from newer NICE recommended treatments that have already helped extend her life.

Ms Dill was 45 when she was first diagnosed with a rare form of blood cancer, plasmacytoma, that then developed into myeloma. 

“One day, 13 years ago, I woke up with double vision. My life was turned upside down by the diagnosis. I had two children aged 7 and 9.”

More treatments, better outcomes

Ms Dill has been having myeloma treatment, including two stem cell transplants since 2014. People diagnosed today face a better treatment landscape than a decade ago.

“When I was first treated for multiple myeloma, there was only one medicine available for me. When I relapsed 18 months later, there was still only one treatment available for me. However, when I relapsed again in 2019 a whole plethora of drugs had been introduced.”

Since 2019 Ms Dill has had two new treatments that were unavailable at the time of her diagnosis. Following NICE appraisals, the new treatments were recommended for NHS use via the Cancer Drugs Fund (CDF) and Ms Dill was prescribed them. 

“That is why I am still here. They have given me a further 5 years with my family, and I am having the longest remission I have ever had.”

Figure 1: Number of blood cancer treatment recommendations made by NICE, 2001-2024

Note: Data up to 31 December 2024. Excludes terminated appraisals. Source: NICE

NICE has made 97 positive recommendations for blood cancer treatments over the last decade, five times more than in the previous ten years. 92% of blood cancer treatment recommendations since 2015 have been positive.

The increase in positive recommendations reflects the expansion of the research and development of new treatments with clinical trials showing the treatments work well.

It also reflects the introduction of a refreshed Cancer Drugs Fund in 2016 and a more joined up approach between NICE and NHSE for cancer treatments. Several innovative blood cancer treatments have been made available sooner through this route while additional evidence of effectiveness is collected. 

We have a strong track record of getting the most cost-effective treatments to patient fast while ensuring good value for money for the taxpayer.

The strong success rate shows that NICE has been able to recommend a high number of effective blood cancer drugs that are good value for money. We will keep focusing on what matters most to recommend new blood cancer treatments while ensuring value for the taxpayer.

Helen Knight, director of medicines evaluation at NICE 

Figure 2: Number of people starting a NICE-recommended blood cancer treatment in England

Note: Data includes people treated in the NHS. Source: NHS England.

A record 21,700 people started a NICE-recommended blood cancer treatment in the NHS in England during 2024. This is 13 times more than in 2016, the first year with robust data. These figures will include people that have received more than one treatment.

Dr Deepak Mannari, consultant haematologist at Musgrove Park Hospital and committee member for the NICE blood cancer guidelines said:

“There have been so many new treatments that it has changed the way we treat as haematologists. We have had to specialise and go more disease specific, because there are too many drugs now for us to be able to expertly be able to treat all patients with all these new drugs. It is very impressive.”

Many of the new targeted therapies don’t typically require hospital admission, helping patients and reducing pressure on the NHS.

“The new targeted therapies have been a great breakthrough. They are less toxic than traditional chemotherapy, which means that we can give them to more people, including older or less fit patients.

“It is a paradigm shift, and the more intensive old-fashioned chemotherapy is being almost superseded by these newer drugs,” Dr Mannari added. 

Ms Dill said: “There are now so many more treatment options available for people with myeloma. There is no cure, but the future does look much brighter. The situation is unrecognisable from the time I was diagnosed.”

The following chart compares the estimated survival of adults diagnosed between 2006 and 2010 with those diagnosed between 2016 and 2020, the latest data available.

Figure 3: Blood cancer survival in England. 5-year estimated net survival for adults diagnosed with common types of blood cancer

Note: Includes individuals aged 15 to 99. Source: NHS England.

Myeloma saw the biggest improvement: 40% of adults diagnosed between 2006 and 2010 survived five years or more, which increased to about 1 in 2 patients (52%) for those diagnosed between 2016 and 2020.

For leukaemia, the survival rate for adults diagnosed from 2006 to 2010 was 45%, which rose to 55% a decade later. Hodgkin lymphoma and non-Hodgkin lymphoma saw smaller, but still important increases in 5-year survival during this period. 

Research from Blood Cancer UK conducted in 2019 showed that blood cancer survival in England was improving faster than other cancer types. Another analysis by the charity found a big improvement in childhood survival.

"In the last 15 years, the improvements in survival we have seen have been nearly all due to the anti-cancer therapies now available," Dr Mannari notes. "We've seen particularly significant improvements with the newer treatments."

One of the greatest advancements of the last decade has been CAR-T – chimeric antigen receptor T-cell – therapy, specifically designed for each individual patient. Treatment involves the patient's immune cells being genetically modified to attack cancer cells before being infused back into the body. While complex and with significant risks, it has cured some patients with advanced cancers where other treatments failed.

NICE has recommended CAR-T therapies for both leukaemia and lymphoma.

Some blood cancers are diagnosed with a blood test—a simpler procedure than obtaining tissue samples—which may enable earlier interventions, research, and trials of experimental therapies that could lead to better outcomes. However, many patients will need further investigations, including a bone marrow biopsy.

Improved transplantation techniques have made donor stem cell transplants less toxic, expanding their availability to a wider population. Additionally, innovative monitoring techniques may be contributing to improved survival, particularly for children and young people.

Ms Dill said: “I have had the privilege of seeing my children from primary school through to university. I never would have dreamed to see these days. What is more incredible is that even more drugs have been approved since the last time I relapsed. When I relapse again there is a whole range of other treatments that I could have, so I am hoping to be here for a few years.” 

Ms Dill concluded: “Myeloma is very clever—it manages to find its way around new treatments every time and always comes back. The important thing for people with myeloma is having as many treatment options available as possible, since everyone respond differently to different treatment combinations.”

Notes

• Rosie Dill has taken part in several NICE technology appraisals as a patient expert. 

• Some treatments can be recommended more than once if the guidance is reviewed and changed.

• The eligible population for blood cancer treatments recommended in 2024 is approximate as the complexity of treatment pathways means it is difficult to calculate a precise figure.