2016 Hematological Malignancies

Timing of peri-transplant RT PRE- transplant Pros: • Cytoreduction if poor salvage chemo response • Less haematological toxicity • Ensures administration Cons: • Higher risk of pneumonitis • Delay of HD chemo • Requires good co-ordination POST- transplant Pros: • Less pneumonitis • Less GI toxicity / VOD • No delay in giving HD chemo Cons: • More haematological toxicity: – Irradiating regenerating marrow – MDS / leukemogenic risk • May be delayed or omitted if recovery is prolonged