Hematopoietic Cell Transplantation in the Treatment of Germ Cell Tumors

This policy covers hematopoietic cell transplantation—primarily single or tandem autologous HCT and sequential high‑dose chemotherapy—as salvage therapy for germ cell tumors (testicular, ovarian, and extragonadal), including patients who have failed conventional‑dose salvage chemotherapy, those with unfavorable prognostic factors at first relapse, and platinum‑refractory disease. Major limitations: autologous HCT is not indicated as first‑line therapy and allogeneic HCT (including after failed autologous HCT) is considered experimental/uncovered; candidates must be appropriately staged, medically fit for intensive conditioning and typically in remission before transplant, with intensive post‑transplant surveillance required.

"Single autologous HCT as salvage therapy for germ cell tumors in individuals with favorable prognostic factors who have failed a previous course of conventional‑dose salvage chemotherapy."