Disease Subtype(s) HCT Disease Inserts Required Cellular Therapy Disease Inserts Required
  • Acquired AA, not otherwise specified (301)
  • Acquired AA secondary to chemotherapy (313)
  • Acquired SAA secondary to hepatitis (302)
  • Acquired AA secondary to immunotherapy or immune effector cell therapy (314)
  • Acquired AA secondary to toxin/other drug (303)
  • Acquired amegakaryocytosis (not congenital) (304)
  • Acquired pure red cell aplasia (not congenital) (306)
  • Other acquired cytopenic syndrome (309)
Forms 2028 & 2128 No disease inserts required
Last modified: Feb 17, 2026