Hematopoietic Cell Transplantation for Thalassemia Major and Sickle Cell Anemia (CPB 0626, reviewed 2025-09-25)
Summary
Aetna's Clinical Policy Bulletin 0626 covers allogeneic hematopoietic cell transplantation (HCT) for thalassemia major and sickle cell anemia. Aetna considers allogeneic HCT medically necessary for thalassemia major in children or young adults (to age 45 years) when the member meets the transplanting institution's written eligibility criteria, and in the absence of such criteria when a haploidentical or HLA-matched donor is used. For sickle cell anemia in children or young adults, allogeneic HCT is medically necessary when the member meets the transplanting institution's written eligibility criteria, and in the absence of such criteria when the member has a haploidentical or HLA-matched donor and either a history of stroke or an increased risk of stroke or end-organ damage. Autologous HCT for these conditions, treosulfan-based T-cell depleted haplo-identical stem cell transplantation for sickle cell disease or transfusion-dependent thalassemia, and use of T-lymphocyte subsets at engraftment to predict the risk of acute graft-versus-host disease in thalassemia major are considered experimental, investigational, or unproven.
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