Hematopoietic Cell Transplantation for Non-Hodgkin's Lymphoma

Aetna covers autologous HCT as medically necessary for relapsed or primary refractory NHL (and select high‑risk first‑remission histologies) when the patient meets the transplanting institution’s protocol eligibility or, absent a protocol, has relapsed/refractory, chemotherapy‑responsive disease and no serious organ dysfunction; autologous HCT may also be considered for certain chemoresistant, widely metastatic cases when allogeneic HCT is not an option. Allogeneic HCT is covered for relapsed or primary refractory NHL if institutional eligibility is met and an acceptable donor is available (haploidentical to fully HLA‑matched related, well‑matched unrelated per NMDP, or cord blood ≥4/6 HLA match); tandem auto‑auto or auto‑allo transplants and transplants in patients with significant comorbidities/organ dysfunction are considered experimental/investigational and excluded.

"In patients with relapsed/refractory aggressive NHL, ASCT results in long‑term disease‑free survival in a substantial proportion (40–50%) and is thus an appropriate salvage option for chemosensitiv..."