Indications for Autologous and Allogeneic Hematopoietic Cell Transplantation
Publication Date: August 7, 2015
Last Updated: March 14, 2022
Indications for HCT in pediatric patients (generally age <18 years)
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| Indication and Disease Status | Allogeneic HCT | Autologous HCT |
|---|---|---|
| Acute myeloid leukemia | ||
| CR1, low risk | N | N |
| CR1, intermediate risk | C | N |
| CR1, high risk | S | N |
| CR2+ | S | N |
| Not in remission | C | N |
| Acute promyelocytic leukemia, relapse | R | R |
| Acute lymphoblastic leukemia | ||
| CR1, standard risk | N | N |
| CR1, high risk | S | N |
| CR2 | S | N |
| CR3+ | C | N |
| Not in remission | C | N |
| Chronic myeloid leukemia | ||
| Chronic phase | C | N |
| Accelerated phase | C | N |
| Blast phase | C | N |
| Myelodysplastic syndromes | ||
| Low risk | C | N |
| High risk | S | N |
| Juvenile myelomonocytic leukemia | S | N |
| Therapy related | S | N |
| T-cell non-Hodgkin lymphoma | ||
| CR1, standard risk | N | N |
| CR1, high risk | S | N |
| CR2 | S | N |
| CR3+ | C | N |
| Not in remission | C | N |
| Lymphoblastic B-cell non-Hodgkin lymphoma (non-Burkitt) | ||
| CR1, standard risk | N | N |
| CR1, high risk | S | N |
| CR2 | S | N |
| CR3+ | C | N |
| Not in remission | C | N |
| Burkitt's lymphoma | ||
| First remission | C | C |
| First or greater relapse, sensitive | C | C |
| First or greater relapse, resistant | C | N |
| Hodgkin lymphoma | ||
| CR1 | N | N |
| Primary refractory, sensitive | C | C |
| Primary refractory, resistant | C | N |
| First relapse, sensitive | C | C |
| First relapse, resistant | C | N |
| Second or greater relapse | C | C |
| Anaplastic large cell lymphoma | ||
| CR1 | N | N |
| Primary refractory, sensitive | C | C |
| Primary refractory, resistant | C | N |
| First relapse, sensitive | C | C |
| First relapse, resistant | C | N |
| Second or greater relapse | C | C |
| Solid tumors | ||
| Germ cell tumor, relapse | D | C |
| Germ cell tumor, refractory | D | C |
| Ewing's sarcoma, high risk or relapse | D | S |
| Soft tissue sarcoma, high risk or relapse | D | D |
| Neuroblastoma, high risk or relapse | D | S |
| Wilm's tumor, relapse | N | C |
| Osteosarcoma, high risk | N | C |
| Medulloblastoma, high risk | N | C |
| Other malignant brain tumors | N | C |
| Non-malignant diseases | ||
| Severe aplastic anemia, new diagnosis | S | N |
| Severe aplastic anemia, relapse/refractory | S | N |
| Fanconi's anemia | R | N |
| Dyskeratosis congenita | R | N |
| Blackfan-Diamond anemia | R | N |
| Sickle cell disease | C | N |
| Thalassemia | S | N |
| Congenital amegakaryocytic thrombocytopenia | R | N |
| Severe combined immunodeficiency | R | N |
| T cell immunodeficiency, SCID variants | R | N |
| Wiskott-Aldrich syndrome | R | N |
| Hemophagocytic disorders | R | N |
| Lymphoproliferative disorders | R | N |
| Severe congenital neutropenia | R | N |
| Chronic granulomatous disease | R | N |
| Other phagocytic cell disorders | R | N |
| IPEX syndrome | R | N |
| Juvenile rheumatoid arthritis | D | R |
| Systemic sclerosis | D | R |
| Other autoimmune and immune dysregulation disorders | R | N |
| Mucopolysaccharoidoses (MPS-I and MPS-VI) | R | N |
| Other metabolic diseases | R | N |
| Osteopetrosis | R | N |
| Globoid cell leukodystrophy (Krabbe) | R | N |
| Metachromatic leukodystrophy | R | N |
| Cerebral X-linked Adrenoleukodystrophy | R | N |
Rather than provide a long and evolving list of unique rare diseases, the indications table shows a concise categorical list together with selected unique diagnoses for which transplant is most frequently offered
Recommendation categories (see text for definition): Standard of care (S); Standard of care, clinical evidence available (C); Standard of care, rare indication (R); Developmental (D); Not generally recommended (N)
Indications for hematopoietic cell transplantation in adults (generally age ≥18 years)
Having trouble viewing table?
| Indication and Disease Status | Allogeneic HCT | Autologous HCT |
|---|---|---|
| Acute myeloid leukemia | ||
| CR1, low risk | N | C |
| CR1, intermediate risk | S | C |
| CR1, high risk | S | C |
| CR2 | S | C |
| CR3+ | C | C |
| Not in remission | C | N |
| Acute promyelocyte leukemia | ||
| CR1 | N | N |
| CR2, molecular remission | C | S |
| CR2, not in molecular remission | S | N |
| CR3+ | C | N |
| Not in remission | C | N |
| Relapse after autologous transplant | C | N |
| Acute lymphoblastic leukemia | ||
| CR1, standard risk | S | C |
| CR1, high risk | S | N |
| CR2 | S | C |
| CR3+ | C | N |
| Not in remission | C | N |
| Chronic myeloid leukemia | ||
| Chronic phase 1, TKI intolerant | C | N |
| Chronic phase 1, TKI refractory | C | N |
| Chronic phase 2+ | S | N |
| Accelerated phase | S | N |
| Blast phase | S | N |
| Myelodysplastic syndromes | ||
| Low/intermeditate-1 risk | C | N |
| Intermediate-2/high risk | S | N |
| Therapy related AML/MDS | ||
| CR1 | S | N |
| Myelofibrosis & myeloproliferative diseases | ||
| Primary, low risk | C | N |
| Primary, intermediate/high risk | C | N |
| Secondary | C | N |
| Hypereosinophilic syndromes, refractory | R | N |
| Plasma cell disorders | ||
| Myeloma, initial response | D | S |
| Myeloma, sensitive relapse | C | S |
| Myeloma, refractory | C | C |
| Plasma cell leukemia | C | C |
| Primary amyloidosis | N | C |
| POEMS syndrome | N | R |
| Relapse after autologous transplant | C | C |
| Hodgkin lymphoma | ||
| CR1 (PET negative) | N | N |
| CR1 (PET positive) | N | C |
| Primary refractory, sensitive | C | S |
| Primary refractory, resistant | C | N |
| First relapse, sensitive | S | S |
| First relapse, resistant | C | N |
| Second or greater relapse | C | S |
| Relapse after autologous transplant | C | N |
| Diffuse large B-cell lymphoma | ||
| CR1 (PET negative) | N | N |
| CR1 (PET positive) | N | C |
| Primary refractory, sensitive | C | S |
| Primary refractory, resistant | C | N |
| First relapse, sensitive | C | S |
| First relapse, resistant | C | N |
| Second or greater relapse | C | S |
| Relapse after autologous transplant | C | N |
| Follicular lymphoma | ||
| CR1 | N | C |
| Primary refractory, sensitive | S | S |
| Primary refractory, resistant | S | N |
| First relapse, sensitive | S | S |
| First relapse, resistant | S | N |
| Second or greater relapse | S | S |
| Transformation to high grade lymphoma | C | S |
| Relapse after autologous transplant | C | N |
| Mantle cell lymphoma | ||
| CR1/PR1 | C | S |
| Primary refractory, sensitive | S | S |
| Primary refractory, resistant | C | N |
| First relapse, sensitive | S | S |
| First relapse, resistant | C | N |
| Second or greater relapse | C | S |
| Relapse after autologous transplant | C | N |
| T-cell lymphoma | ||
| CR1 | C | C |
| Primary refractory, sensitive | C | S |
| Primary refractory, resistant | C | N |
| First relapse, sensitive | C | S |
| First relapse, resistant | C | N |
| Second or greater relapse | C | C |
| Relapse after autologous transplant | C | N |
| Lymphoplasmacytic lymphoma | ||
| CR1 | N | N |
| Primary refractory, sensitive | N | C |
| Primary refractory, resistant | R | N |
| First or greater relapse, sensitive | R | C |
| First or greater relapse, resistant | R | N |
| Relapse after autologous transplant | C | N |
| Burkitt's lymphoma | ||
| First remission | C | C |
| First or greater relapse, sensitive | C | C |
| First or greater relapse, resistant | C | N |
| Relapse after autologous transplant | C | N |
| Cutaneous T-cell lymphoma | ||
| Relapse | C | C |
| Relapse after autologous transplant | C | N |
| Plasmablastic lymphoma | ||
| CR1 | R | R |
| Relapse | R | R |
| Chronic lymphocytic leukemia | ||
| High risk, first or greater remission | C | N |
| T-cell prolymphocytic leukemia | R | R |
| B-cell, prolymphocytic leukemia | R | R |
| Transformation to high grade lymphoma | C | C |
| Solid tumors | ||
| Germ cell tumor, relapse | N | C |
| Germ cell tumor, refractory | N | C |
| Ewing's sarcoma, high risk | N | C |
| Breast cancer, adjuvant high risk | N | D |
| Breast cancer, metastatic | D | D |
| Renal cancer, metastatic | D | N |
| Non-malignant diseases | ||
| Severe aplastic anemia, new diagnosis | S | N |
| Severe aplastic anemia, relapse/refractory | S | N |
| Fanconi's anemia | R | N |
| Dyskeratosis congenita | R | N |
| Sickle cell disease | C | N |
| Thalassemia | D | N |
| Hemophagocytic syndromes, refractory | R | N |
| Mast cell diseases | R | N |
| Common variable immunodeficiency | R | N |
| Wiskott-Aldrich syndrome | R | N |
| Chronic granulomatous disease | R | N |
| Multiple sclerosis | N | D |
| Systemic sclerosis | N | D |
| Rheumatoid arthritis | N | D |
| Systemic lupus erythematosus | N | D |
| Crohn's disease | N | D |
| Polymyositis-dermatomyositis | N | D |
Rather than provide a long and evolving list of unique rare diseases, the indications table shows a concise categorical list together with selected unique diagnoses for which transplant is most frequently offered
Recommendation categories (see text for definition): Standard of care (S); Standard of care, clinical evidence available (C); Standard of care, rare indication (R); Developmental (D); Not generally recommended (N)
Recommendation Grading
Overview
Title
Indications for Autologous and Allogeneic Hematopoietic Cell Transplantation
Authoring Organization
American Society for Transplantation and Cellular Therapy
Publication Month/Year
August 7, 2015
Last Updated Month/Year
January 10, 2024
Document Type
Guideline
External Publication Status
Published
Country of Publication
US
Inclusion Criteria
Female, Male, Adolescent, Adult, Child, Infant, Older adult
Health Care Settings
Ambulatory, Hospital, Operating and recovery room, Outpatient
Intended Users
Clinical researcher, nurse, nurse practitioner, physician, physician assistant
Scope
Management, Treatment
Diseases/Conditions (MeSH)
D018380 - Hematopoietic Stem Cell Transplantation, D015470 - Leukemia, Myeloid, Acute, D054198 - Precursor Cell Lymphoblastic Leukemia-Lymphoma
Keywords
clinical trials, Hematopoietic cell transplantation, Autologous transplantation, Allogeneic transplantation
Source Citation
Majhail, N. S., Farnia, S. H., Carpenter, P. A., Champlin, R. E., Crawford, S., Marks, D. I., Omel, J. L., Orchard, P. J., Palmer, J., Saber, W., Savani, B. N., Veys, P. A., Bredeson, C. N., Giralt, S. A., & LeMaistre, C. F. (2015). Indications for Autologous and Allogeneic Hematopoietic Cell Transplantation: Guidelines from the American Society for Blood and Marrow Transplantation. Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation, 21(11), 1863–1869. https://doi.org/10.1016/j.bbmt.2015.07.032