446 / 1631
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
•
Timing of harvest
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