Hematopoietic Cell Transplantation for Waldenstrom Macroglobulinemia

This policy covers hematopoietic cell transplantation—primarily autologous HCT—for symptomatic Waldenström macroglobulinemia (WM), including use as salvage therapy for chemosensitive disease and for restoration of bone marrow function after marrow‑toxic therapy. Coverage is limited to chemosensitive, salvage settings (not frontline or chemo‑refractory disease), excludes allogeneic HCT as experimental/unproven, disallows treatment of asymptomatic patients or those with >3 prior systemic therapies or who are unfit for myeloablative conditioning, and remains subject to member benefit plan and state regulatory limits.

"Autologous hematopoietic cell transplantation (HCT) may be considered medically necessary as salvage therapy for chemosensitive Waldenström macroglobulinemia (WM)."

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