Allogeneic Hematopoietic Cell Transplants for Sickle Cell Anemia and β-Thalassemia

This policy covers allogeneic and selected autologous hematopoietic cell transplantation (bone marrow, peripheral blood, or cord blood) and related peri‑transplant services as curative therapy for sickle cell anemia and homozygous β‑thalassemia, including transplantation for transfusion‑dependent thalassemia and pediatric sickle cell patients who meet clinical criteria. Coverage requires appropriate clinical indications and donor matching (e.g., HLA‑matched first‑degree donor for certain sickle cell cases, transfusion dependence or qualifying risk category for thalassemia, and planned conditioning regimens), excludes transplants performed as part of gene therapy, and is contraindicated or limited for uncontrolled active infections, inability to adhere to post‑transplant care, active substance use, significant organ dysfunction/iron overload, older age, or other factors that increase GVHD/rejection risk.

"Allogeneic hematopoietic cell transplant (HCT) as a curative therapy for sickle cell anemia when medically appropriate."