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Hematopoietic Cell Transplantation for Central Nervous System Embryonal Tumors and Ependymoma

Embryonal Tumors of the Central Nervous System
Autologous Hematopoietic Cell Transplantation

Autologous hematopoietic cell transplantation may be considered medically necessary as consolidation therapy for previously untreated embryonal tumors of the central nervous system (CNS) that show partial or complete response to induction chemotherapy, or stable disease after induction therapy (see Policy Guidelines section).

Autologous hematopoietic cell transplantation may be considered medically necessary to treat recurrent embryonal tumors of the CNS.

Tandem autologous hematopoietic cell transplantation is investigational to treat embryonal tumors of the CNS.

Allogeneic Hematopoietic Cell Transplantation

Allogeneic hematopoietic cell transplantation is investigational to treat embryonal tumors of the CNS.

Ependymoma

Autologous, tandem autologous, and allogeneic hematopoietic cell transplantation are investigational to treat ependymoma.

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