Hematopoietic cell transplant (HCT) consultation guidelines & outcomes
Evidence-based guidance to help identify the right patients—and the right timing—for transplant consultation
Early consultation for allogeneic HCT or autologous HCT is critical for many hematologic malignancies and non-malignant disorders. This page brings together disease-specific indications, patient eligibility considerations and outcomes data to support timely referral decisions in collaboration with a transplant center.
Get referral timing guidance at the point of care
Access the evidence-based guidelines quickly using the HCT consultation guidelines app—available for iOS and Android devices.
- Search by disease for 20+ indications, including adult and pediatric leukemias and myelodysplasia, lymphomas, other malignant diseases and non-malignant disorders
- Review consultation timing recommendations based on risk for disease progression
- Find outcomes data for many indications
You can also access the web-based guidelines below or download a PDF.
Why early HCT consultation matters
Early referral is a key factor in achieving optimal transplant outcomes. For many conditions, the window for transplant eligibility can be narrow, and delays may limit options or affect outcomes.
Early consultation helps enable:
- Appropriate disease risk stratification
- Timely donor search when allogeneic HCT may be indicated
- Shared decision-making between hematology/oncology practices and transplant centers
Disease-specific indications for HCT consultation
Clear, disease-specific guidance is available to help you determine when to consult a transplant center, based on patient diagnosis, disease status and risk for disease progression. The guidelines—organized by disease—include current advances, outcomes and consultation timing considerations to support your clinical decision-making. Access below or download the iOS app or Android app.
NMDPSM and the American Society for Transplantation and Cellular Therapy (ASTCT) jointly developed the Recommended Timing for Transplant Consultation guidelines. The guidelines are based on current clinical practice, medical literature, National Comprehensive Cancer Network® (NCCN) Guidelines for the treatment of cancer and evidence-based reviews.
Information that supports timely HCT consultation
Eligibility considerations for HCT
Eligibility for HCT is based on a combination of clinical factors and should be evaluated in collaboration with a transplant center.
Common considerations include:
- Patient health
- Performance status
- Comorbidities
- Prior therapies, disease and disease stage
- Psychosocial factors
Age alone should not be used to determine transplant eligibility.
Early consultation is appropriate even when candidacy is uncertain.
Identifying a donor early
If a patient may be a candidate for allogeneic HCT, HLA typing and cytogenetic testing at the hematology/oncology practice at the time of diagnosis is a critical first step in the process of finding a related or unrelated donor.
The no-cost NMDP HLA Today program helps remove barriers to HLA typing for hematology/oncology practices.
HLA Today is most beneficial for hematology/oncology practices that:
- don't have access to HLA typing or
- don't have a process in place to conduct HLA typing or
- can't claim insurance reimbursement for typing
HCT outcomes data
New outcomes data and research has defined which patients can benefit from HCT and when allogeneic or autologous HCT is best applied.
Find data from CIBMTR® (Center for International Blood and Marrow Transplant Research®) on:
- Autologous and allogeneic HCT and cell therapy volume, including by transplant type, donor type and recipient age
- Comorbidity index in allogeneic HCT by age
- Graft-versus-host disease prophylaxis by donor type and age
- Overall survival trends and outcomes by disease
CIBMTR is a research collaboration between the Medical College of Wisconsin® and NMDPSM.
Connecting with a transplant center
Consulting a transplant center does not commit a patient to transplant—it helps clarify options while there is still time to act. If your practice doesn't have an established relationship with a transplant center in your area, you can use the U.S. transplant center directory to find the right center for a consultation.
The directory provides an overview of the more than 150 transplant centers nationwide along with center-specific information including:
- Overall survival
- Number of transplants by cell source
- Number of transplants by age and type (related, unrelated, autologous)
- Contact information
- Survivorship programs (if available)
Our NMDP Pathways to Transplant team is also available to help you build relationships with transplant centers in your region. Explore how Pathways to Transplant can assist your practice with personalized support.
Additional pre- and post-HCT resources for your practice
These resources from NMDP may be helpful to support discussions with your patients and their families before and after transplant—and support you as you care for patients after HCT. There's no cost for you or your patients.
- NMDP Patient Support Center offering one-on-one navigation and resources for patients, with staff fluent in English and Spanish and interpreters available
- Patient education materials about HCT that you can order, download or print.
- Jason Carter Clinical Trials Search and Support offering free support to help patients and clinicians to find and join clinical trials for blood cancers and disorders.
- Post-transplant care guidelines available online and in the NMDP Transplant Guidelines iOS app or Android app.
Disease-specific experts
NMDP would like to acknowledge the following disease-specific experts who review and update these guidelines: