The role of radiation therapy in hematopoietic stem cell transplantation

Hematopoietic stem cell transplantation (HSCT) is often indicated for patients with high-risk and relapsed or refractory hematologic cell malignancies. Historically the role of radiation therapy (RT) when combined with allogeneic HSCT was as a form of myeloablative conditioning with total-body irradiation (TBI). However, RT can also be used as a form of treatment intensification when combined with HSCT to improve local control in this patient population at sites of tumor bulk, multiple refractory disease, or in sanctuary areas that systemic therapy alone may not adequately address. In this chapter we review the potential role of external beam radiation therapy in the setting of allogeneic and autologous HSCT for patients with hematologic malignances.