Hematopoietic Cell Transplantation for Genetic Diseases and Acquired Anemias

This policy covers hematopoietic cell transplantation (allogeneic and autologous HCT) and related conditioning approaches (myeloablative and reduced‑intensity conditioning) to restore marrow/immune function or provide graft‑versus‑malignancy effects for genetic diseases and acquired anemias — for example, sickle cell disease with prior or high stroke/end‑organ risk, homozygous β‑thalassemia, aplastic anemias (including Fanconi and other inherited forms), primary immunodeficiencies (e.g., SCID, Wiskott‑Aldrich), certain inherited metabolic storage disorders, infantile malignant osteopetrosis, and hematologic malignancies. Coverage is limited to the specific listed indications (allo‑HCT is experimental for unlisted conditions), autologous HCT is not covered for genetic diseases or acquired anemias, myeloablative regimens are restricted to medically fit patients, some metabolic syndromes (Hunter, Sanfilippo, Morquio) are excluded, and gene‑modified autologous infusions (Casevy, Lyfgenia) are governed by separate policies; post‑transplant immunosuppression and transplant‑related risks apply.