![]() * Some plans may participate in voluntary programs offering coverage for patients participating in NIH-approved clinical trials of cancer chemotherapies, including autologous bone marrow transplantation. The following considerations may supersede this policy: * State mandates requiring coverage for autologous bone marrow transplantation offered as part of clinical trials of autologous bone marrow transplantation approved by the National Institutes of Health (NIH). * For patients who qualify for a myeloablative allogeneic HCT on the basis of clinical status, either a myeloablative or reduced-intensity conditioning regimen may be considered medically necessary. These include those patients whose age (typically >60 years) or comorbidities (eg, liver or kidney dysfunction, generalized debilitation, prior intensive chemotherapy, low Karnofsky Performance Status) preclude use of a standard myeloablative conditioning regimen. * Some patients for whom a conventional myeloablative allotransplant could be curative may be considered candidates for reduced-intensity conditioning allogeneic hematopoietic stem-cell transplantation (HCT). Allogeneic hematopoietic cell transplantation using a reducedintensity conditioning regimen may be considered medically necessary as a treatment of chronic myeloid leukemia in patients who meet clinical criteria for an allogeneic HCT but who are not considered candidates for a myeloablative conditioning allogeneic HCT.Īutologous HCT Autologous HCT is investigational as a treatment of chronic myeloid leukemia. This policy discusses when an allogeneic hematopoietic cell transplant would be medically necessary to treat CML.Īllogeneic hematopoietic cell transplantation (HCT)Īllogeneic hematopoietic cell transplantation (HCT) using a myeloablative conditioning regimen may be considered medically necessary as a treatment of chronic myeloid leukemia. When the cells come from the patient himself, it is called an autologous cell transplant. When the hematopoietic cells are harvested from another person, it is called an allogeneic transplant. It is hoped that these new cells will then settle into the bone marrow and start producing normal blood cells, and the person will no longer have CML. In a hematopoietic cell transplant, hematopoietic cells are taken from a donor’s bone marrow and are given to the person with CML, just like in a transfusion. Another common type of treatment is a hematopoietic cell transplant. Different types of treatment have been used against CML, including chemotherapy and other medications. When a person has CML, they make too many white blood cells. These blood-forming calls are called “hematopoietic” cells. Introduction Chronic myeloid leukemia (CML) is a type of cancer that starts in certain blood-forming cells within the bone marrow. Hematopoietic Cell Transplantation for Chronic Myeloid Leukemia S2150 Bone marrow or blood-derived stem cells (peripheral or umbilical), allogeneic or autologous, harvesting, transplantation and related complications including: pheresis and cell preparation/storage marrow ablative therapy drugs, supplies, hospitalization with outpatient follow-up medical/surgical, diagnostic, emergency, and rehabilitative service and the number of days of pre- and post-transplant care in the global definition S2142 Cord blood derived stem cell transplantation, allogeneic S2140 Cord blood harvesting for transplantation, allogeneic 38230 Bone marrow harvesting for transplantation allogeneicģ8232 Bone marrow harvesting for transplantation autologousģ8240 Hematopoietic progenitor cell (HPC) allogeneic transplantation per donorģ8241 Hematopoietic progenitor cell (HPC) autologous transplantation
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