Multiple Myeloma
A single or second (salvage) autologous hematopoietic cell transplantation may be considered medically necessary to treat multiple myeloma.
Tandem autologous hematopoietic cell transplantation may be considered medically necessary to treat multiple myeloma in patients who fail to achieve at least a near-complete or very good partial response after the first transplant in the tandem sequence. (For definitions of near-complete response and very good partial response, see Policy Guidelines section.)
Tandem transplantation with an initial round of autologous hematopoietic cell transplantation followed by a non-marrow-ablative conditioning regimen and allogeneic hematopoietic stem cell transplantation (ie, reduced-intensity conditioning transplant) may be considered medically necessary to treat newly diagnosed multiple myeloma patients.
Allogeneic hematopoietic cell transplantation, myeloablative or nonmyeloablative, as upfront therapy of newly diagnosed multiple myeloma or as salvage therapy, is considered investigational.
POEMS Syndrome
Autologous hematopoietic cell transplantation may be considered medically necessary to treat disseminated POEMS syndrome (see Policy Guidelines section).
Allogeneic and tandem hematopoietic cell transplantation are considered investigational to treat POEMS syndrome.
