Hematopoietic cell transplantation (HCT) refers to a procedure in which hematopoietic cells are infused to restore bone marrow function in cancer individuals who receive bone-marrow-toxic doses of cytotoxic drugs with or without whole-body radiation therapy. Hematopoietic cells may be obtained from the transplant recipient (autologous HCT) or from a donor (allogeneic HCT) and can be harvested from bone marrow, peripheral blood, or umbilical cord blood shortly after delivery of neonates.
Allogeneic HCT may be considered medically necessary to treat:
Use of a myeloablative or reduced-intensity pre-transplant conditioning regimen should be individualized based on factors that include individuals age, the presence of comorbidities, and disease burden.
Autologous HCT is considered experimental/investigational, and therefore, non-covered to treat chronic lymphocytic leukemia or small lymphocytic lymphoma. Available scientific evidence does not permit conclusions concerning the effect of autologous HCT on health outcomes for chronic lymphocytic leukemia or small lymphocytic lymphoma.