Hematopoietic Cell Transplantation for Chronic Myeloid Leukemia

This policy covers allogeneic hematopoietic cell transplantation (allo‑HCT) as medically necessary treatment for chronic myeloid leukemia (CML), including Ph chromosome/BCR‑ABL–positive disease and patients with progression on or resistance/intolerance to tyrosine kinase inhibitors (including T315I) and blast‑phase disease, and includes related pretransplant HLA typing, conditioning and post‑graft immunosuppression. Autologous HCT is considered experimental and not covered; allo‑HCT requires adequate HLA matching, medical fitness for intensive conditioning (myeloablative regimens generally limited to ~50–55 years of age), and carries significant risks (organ toxicity, GVHD, opportunistic infections), with conditioning intensity and other specifics not detailed in this excerpt.

"Allogeneic hematopoietic cell transplantation (HCT) is medically necessary for treatment of chronic myeloid leukemia (CML)."