Indications for haematopoietic cell transplantation and CAR-T for haematological diseases, solid tumours and immune disorders: 2025 EBMT practice recommendations

Abstract

For over two decades, the EBMT has updated recommendations on indications for haematopoietic cell transplantation (HCT) practice based on clinical and scientific developments in the field. This is the ninth special EBMT report on indications for HCT for haematological diseases, solid tumours and immune disorders. Our aim is to provide guidance on HCT indications according to prevailing clinical practice in EBMT countries and centres. In order to inform patient decisions, these recommendations must be considered with the risk of the disease, risk of HCT procedure and non-HCT strategies, including evolving cellular therapies, and their availability on site. HCT techniques are constantly evolving and we make no specific recommendations, but encourage harmonisation of practice, where possible, to ensure experience across indications can be meaningfully aggregated via registry outputs. We also recommend working according to JACIE certification standards to maintain quality in clinical and laboratory practice, including benchmarking of survival outcomes [1, 2–3]. Since the last edition, innovative cellular and gene therapies have entered in activity across indications affecting clinical decision making. As the number and type of regulatory authority-approved cellular therapies grow, recommendations for best practice and quality of patient care were developed to support clinicians and will be regularly updated.