Hematopoietic Cell Transplantation for Selected Leukemias

Allogeneic hematopoietic cell transplantation (including reduced‑intensity/non‑myeloablative) is covered for ALL when patients meet the transplanting institution’s selection criteria (or, in the absence of such criteria, for primary refractory ALL), except not for refractory relapse unresponsive to ≥3 months of adequate chemotherapy; autologous HCT is covered for AML when institutional criteria are met (or, without such criteria, for any indication other than first‑line therapy). Autologous HCT for ALL, tandem transplants for ALL, repeat allogeneic HCT for persistent/progressive AML not in remission, repeat autologous HCT for AML, and autologous HCT for CMML/JMML are considered experimental/investigational.

"Documentation of discussion of risks (including TRM) and alternative therapies, and rationale for transplant given patient risk profile and available evidence."