Table 2.

Summary of American Society of Hematology (ASH) Recommendations (R) for HSCT in Patients With SCD.

R1	The ASH guideline panel suggests HLA-matched related HSCT rather than standard of care (HU/transfusion) in patients with SCD who have experienced an overt stroke or have an abnormal transcranial Doppler ultrasound (TCD). When considering transplantation for neurologic injury, children younger than age 16 years who receive MSD HSCT have better outcomes than those older than age16 years.
R2	For patients with frequent pain, the ASH guideline panel suggests using related matched allogeneic transplantation rather than standard of care.
R3	For patients with recurrent episodes of ACS, the ASH guideline panel suggests using matched related allogeneic transplantation over standard of care.
R4	For patients with SCD with an indication for HSCT who lack an MSD, the ASH guideline panel suggests using transplants from alternative donors in the context of a clinical trial.
R5	For allogeneic HSCT, the ASH guideline panel suggests using either total body irradiation (TBI) ≤400 cGy or chemotherapy-based conditioning regimens.
R6	a. For children with SCD who have an indication for allogeneic HSCT and an MSD, the ASH guideline panel suggests using myeloablative conditioning over RIC that contains melphalan/fludarabine regimen. b. For adults with SCD who have an indication for allogeneic HSCT and an MSD, the ASH guideline panel suggests nonmyeloablative conditioning over RIC that contains melphalan/fludarabine regimens.
R7	In patients with an indication eligible for HSCT, the ASH guideline panel suggests using allogeneic transplantation at an earlier age rather than an older age.
R8	The ASH guideline panel suggests the use of HLA-identical sibling cord blood when available (and associated with an adequate cord blood cell dose and good viability) over bone marrow (BM).

ACS: acute chest syndrome; HU: hydroxyurea; MSD: matched sibling donor; RIC: reduced intensity conditioning.