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<p>As the treatments referred to are mutually exclusive, NHS England has no plans
to carry out such an assessment. Patients will only be offered a transplant when they
are unsuitable for tyrosine kinase inhibitor (TKI) treatment, or if this treatment
has failed.</p><br /><p>Both imatinib (usually considered the first line option) and
nilotinib are recommended by the National Institute for Health and Care Excellence
as cost effective treatments for chronic myeloid leukaemia (CML). Dasatinib, bosutinib
and ponatinib are only available for certain patients through the Cancer Drugs Fund.</p><p>In
2013, NHS England published a policy for the routine commissioning of allogeneic stem
cell transplant for CML. This can be found at:</p><br /><p><a href="http://www.england.nhs.uk/commissioning/wp-content/uploads/sites/12/2015/01/b04-haematp-stem-cll-transplt.pdf"
target="_blank">www.england.nhs.uk/commissioning/wp-content/uploads/sites/12/2015/01/b04-haematp-stem-cll-transplt.pdf</a></p><p>This
policy allows for transplant in patients whose CML is refractory to TKI treatment,
or where the patient is TKI intolerant. It takes into account expert advice from the
British Society for Blood and Marrow Transplantation.</p><p>Based on the clinical
pathway of care, no specific assessment of cost or effectiveness comparing blood and
marrow transplantation with TKI has been undertaken.</p><br /><p><strong></strong></p><p><strong></strong></p><p><strong></strong></p><p><strong></strong></p><p><strong></strong></p><p><strong></strong></p><p><strong></strong></p><p><strong></strong></p>
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