Other Malignant and Non-Malignant Diseases
Although chemotherapy or other therapies are appropriate for many patients with the diseases listed below, hematopoietic cell transplantation (HCT) may also be indicated in select patient cohorts.
Malignant Diseases
Germ cell tumors
- Ovarian cancer
- Testicular cancer
Myeloproliferative neoplasms (MPN) [1,2,3]
(including BCR-ABL-negative myeloproliferative neoplasms, Polycythemia vera, Essential thrombocytosis)
Myelofibrosis (MF)
Ewing family of tumors [6]
Medulloblastoma
Non-Malignant Diseases
Hemophagocytic lymphohistiocytosis (HLH) [7]
Referral Timing Guidelines
These guidelines highlight disease categories that include patients at risk for disease progression and who should be referred for a consultation for autologous or allogeneic transplantation. [8]
Transplant Consultation Guidelines: Other Malignant Diseases
Germ cell tumors
- Poor initial response
- Short initial remission
Neuroblastoma
- INSS stage 2 or 3 at diagnosis
- MYCN amplification (>4x above reference)
- INSS stage 4 at diagnosis
- MYCN amplification (>4x above reference)
- age >18 months at diagnosis
- age 12-18 months with unfavorable characteristics
- Metastatic disease at diagnosis
- Progressive disease while on therapy or relapsed disease
Ewing Family of Tumors
- Metastatic disease at diagnosis
- First relapse or CR2
Medulloblastoma
- First relapse or CR2
Myeloproliferative Neoplasms (MPN)
(including BCR-ABL-negative myeloproliferative neoplasms, myelofibrosis and later stages of polycythemia vera and essential thrombocytosis)
High resolution HLA typing is recommended at diagnosis for all patients
Intermediate- or high-risk disease including:
- High-risk cytogenetics
- Poor initial response or at progression
Myelofibrosis (MF)
- DIPSS Intemediate-2 (INT-2) and high risk disease
- DIPSS Intermediate-1 (INT-1) with low platelet counts, red blood cell transfusion dependent, complex cytogenetics
- High risk driver mutations (ASXL1, EZH2, TET2, IDH1, IDH2, SRSF2, and TP53) or triple negative (lack of a driver mutation such as JAK2, MPL, or CALR) should be considered in decision making
Transplant Consultation Guidelines: Other Non-Malignant Diseases
Hemophagocytic Lymphohistiocytosis (HLH)
- At diagnosis
References
- Tefferi A. How I treat myelofibrosis. Blood. 2011; 117(13): 3494-3504. Access
- Kröger NM, et al. Indication and management of allogeneic stem cell transplantation in primary myelofibrosis: a consensus process by an EBMT/ELN international working group. Leukemia. 2015; 29(11): 2126-2133. Access
- Deeg HJ, et al. Hematopoietic cell transplantation as curative therapy for patients with myelofibrosis: Long-term success in all age groups. Biol Blood Marrow Transplant. 2015; 21(11): 1883-1887. Access
- Hale GA, Arora M, Ahn KW. Allogeneic hematopoietic cell transplantation for neuroblastoma: The CIBMTR experience. Bone Marrow Transplant. 2013; 48(8): 1056-1064. Access
- Pinto NR, Applebaum MA, Volchenboum SL, et al. Advances in Risk Classification and Treatment Strategies for Neuroblastoma. J Clin Oncol. 2015;33:3008-3017. Access
- Gaspar N, Hawkins DS, Dirksen U, et al. Ewing Sarcoma: Current Management and Future Approaches Through Collaboration. J Clin Oncol. 2015;33:3036-3046. Access
- Seo JJ. Hematopoietic cell transplantation for hemophagocytic lymphohistiocytosis: recent advances and controversies. Blood Res. 2015; 50(3): 131-139. Access
- NMDP/Be The Match and ASBMT Recommended Timing for Transplant Consultation. Download (PDF)