945 / 1498
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