title: Indications for Autologous and Allogeneic Hematopoietic Cell Transplantation: Guidelines from the American Society for Blood and Marrow Transplantation.
abstract: Approximately 20,000 hematopoietic cell transplantation (HCT) procedures are performed in the United States annually. With advances in transplantation technology and supportive care practices, HCT has become safer, and patient survival continues to improve over time. Indications for HCT continue to evolve as research refines the role for HCT in established indications and identifies emerging indications where HCT may be beneficial. The American Society for Blood and Marrow Transplantation (ASBMT) established a multiple-stakeholder task force consisting of transplant experts, payer representatives, and a patient advocate to provide guidance on "routine" indications for HCT. This white paper presents the recommendations from the task force. Indications for HCT were categorized as follows: (1) Standard of care, where indication for HCT is well defined and supported by evidence; (2) Standard of care, clinical evidence available, where large clinical trials and observational studies are not available but HCT has been shown to be effective therapy; (3) Standard of care, rare indication, for rare diseases where HCT has demonstrated effectiveness but large clinical trials and observational studies are not feasible; (4) Developmental, for diseases where preclinical and/or early phase clinical studies show HCT to be a promising treatment option; and (5) Not generally recommended, where available evidence does not support the routine use of HCT. The ASBMT will periodically review these guidelines and will update them as new evidence becomes available.
authors.affiliation: Blood & Marrow Transplant Program, Cleveland Clinic, Cleveland, OH.
authors.forename: Navneet S
authors.initials: NS
authors.lastname: Majhail
authors.affiliation: Payer Policy, National Marrow Donor Program, Minneapolis, MN.
authors.forename: Stephanie H
authors.initials: SH
authors.lastname: Farnia
authors.affiliation: Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA.
authors.forename: Paul A
authors.initials: PA
authors.lastname: Carpenter
authors.affiliation: Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: Richard E
authors.initials: RE
authors.lastname: Champlin
authors.affiliation: Cigna LifeSource Transplant Network, Pittsburgh, PA.
authors.forename: Stephen
authors.initials: S
authors.lastname: Crawford
authors.affiliation: Adult BMT Unit, University Hospitals Bristol NHS Foundation Trust, Bristol, UK.
authors.forename: David I
authors.initials: DI
authors.lastname: Marks
authors.affiliation: Grand Island, NE.
authors.forename: James L
authors.initials: JL
authors.lastname: Omel
authors.affiliation: Department of Pediatrics, University of Minnesota, Minneapolis, MN.
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Orchard
authors.affiliation: Division of Hematology/Oncology, Mayo Clinic, Phoenix, AZ.
authors.forename: Jeanne
authors.initials: J
authors.lastname: Palmer
authors.affiliation: Division of Hematology and Oncology, Medical College of Wisconsin, Milwaukee, WI.|Center for International Blood and Marrow Transplant Research, Milwaukee, WI.
authors.forename: Wael
authors.initials: W
authors.lastname: Saber
authors.affiliation: Division of Hematology/Oncology, Vanderbilt University Medical Center, Nashville, TN.
authors.forename: Bipin N
authors.initials: BN
authors.lastname: Savani
authors.affiliation: Bone Marrow Transplantation Unit, Great Ormond Street Hospital for Children, London, UK.
authors.forename: Paul A
authors.initials: PA
authors.lastname: Veys
authors.affiliation: Malignant Hematology & Stem Cell Transplantation, The Ottawa Hospital, Ottawa, ON.
authors.forename: Christopher N
authors.initials: CN
authors.lastname: Bredeson
authors.affiliation: Adult Bone Marrow Transplant Service, Memorial Sloan Kettering Cancer Center, New York, NY.
authors.forename: Sergio A
authors.initials: SA
authors.lastname: Giralt
authors.affiliation: Sarah Cannon, Nashville, TN.
authors.forename: Charles F
authors.initials: CF
authors.lastname: LeMaistre
mesh_terms: D000328:Adult; D000367:Age Factors; D016026:Bone Marrow Transplantation; D002648:Child; D002986:Clinical Trials as Topic; D019337:Hematologic Neoplasms / Q000473:pathology / Q000628:therapy*; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D035583:Rare Diseases / Q000473:pathology / Q000628:therapy*; D012955:Societies, Medical; D059039:Standard of Care; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous; D014481:United States
keywords: Allogeneic transplantation; Autologous transplantation; Clinical trials; Hematopoietic cell transplantation; Indications; Routine care; Standard of care