Hematopoietic Cell Transplantation for Chronic Myelogenous Leukemia

Allogeneic hematopoietic cell transplantation (HCT) is covered for chronic myelogenous leukemia (CML) when the member meets the transplanting institution’s written eligibility criteria, while autologous HCT is experimental/investigational and not covered for CML. If the institution has no written criteria, allogeneic HCT is covered only for patients who have failed, are resistant to, or are intolerant of TKIs (imatinib, dasatinib, nilotinib) and who lack serious organ dysfunction per the transplant center’s evaluation; candidacy is also influenced by disease phase, age, donor availability, and comorbidities.

"Allogeneic hematopoietic cell transplantation is medically necessary for the treatment of chronic myelogenous leukemia (CML) when the member meets the transplanting institution's written eligibilit..."

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