Hematopoietic Cell Transplantation for Chronic Lymphocytic Leukemia (CLL) and Small Lymphocytic Lymphoma (SLL)

This policy covers hematopoietic cell transplantation (HCT) for chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL), specifying allogeneic HCT as medically necessary for patients with poor‑risk disease markers (e.g., TP53 mutation/del(17p), del(11q), complex karyotype, or unfavorable IGHV status) and treating CLL/SLL as a single disease entity. Autologous HCT is considered experimental/unproven for CLL/SLL; allogeneic HCT is limited to patients who meet the policy’s staging/prognostic criteria with appropriate HLA donor matching, and myeloablative conditioning is reserved for medically fit patients due to high treatment‑related mortality, GVHD, and infection risks.

"Allogeneic hematopoietic cell transplantation (HCT) may be considered medically necessary to treat CLL or SLL in individuals with markers of poor‑risk disease (see Staging and Prognosis of CLL/SLL)."