Page 6 of 6 
I understand that if I have further questions, comments, or concerns about the study or 
the informed consent process, I may write or call the office of the Vice Chancellor- 
Research Programs, 3134 Murphy Hall, UCLA, Los Angeles, CA 90024, (310) 825- 
8714. 
In signing this consent form, I acknowledge receiving a copy of the form as well as a 
copy of the Subjects’ Bill of Rights. 
Treatment, Test, Biopsy and Follow-up Schedule: 
One mon th before treatm ent: removal of portion of tumor, draw bl ood (1/6 cup) 
treat ment weeks 1-4: receiv e TIL and PBL on d ay 1; IL-2 o n M,T ,W,Th,F by v ein: 
IFNaA on M, Th unde r skin; optional tumor bi opsies on weeks 
1,2,3; weekly blood draws (1/12 cup); weekly clinic visits. 
treatment weeks 7-10, 
13-16, 1 9-22 : recei ve IL- 2 on M,T,W,Th,F by vein; IFNaA on M,Th under 
skin; weekly blood draws, weekly clinic visits. 
Date 
Signature of Patient 
Time 
Signature of Witness 
HSPC #91-10-442 
Date of expiration 
Recombinant DNA Research, Volume 15 
[559] 
