Bone marrow samples from you will be tested for evidence of HIV five times during the initial period 
of transplantation, then every three months for the next year. In addition, spinal fluid samples from 
you will be obtained prior to the transplant and twice afterwards. 
3. Adoptive immunotherapy with genetically modified HIV specific T cells 
A blood sample (60 ml, approximately four tablespoons) drawn from your arm vein or Hickman 
catheter is required approximately three months before the bone marrow transplant. This sample will 
provide us with your lymphocytes from which we will isolate those that specifically recognize and kill 
HIV infected cells. These cells will be grown in the laboratory, modified by gene transfer 
techniques, and expanded to large numbers to be given back to you following the bone marrow 
transplant. You will be eligible to receive post transplant infusions of genetically modified HIV- 
specific T cells beginning after engraftment has occurred (usually 28-35 days post transplant). HIV 
immune lymphocytes will be infused intravenously through your Hickman catheter every two weeks 
for a total of four infusions. Each infusion will take 30 to 60 minutes and you will be monitored 
during and for two hours after the infusion. This monitoring includes checking your heart rate, blood 
pressure, temperature, respiratory rate and checking blood oxygen saturation by oximetry (this 
measures oxygen by a surface sensor and does not require an arterial puncture). Blood samples (50 
mls/sample, 10 teaspoons) are required from you prior to each infusion, one and seven days after 
each infusion, monthly for four months and every two months for six months following completion of 
immunotherapy. 
If you do not experience toxicity from T cell infusions but require ganciclovir or acyclovir therapy for 
a herpes virus infection which may destroy the genetically modified T cells, repeat infusions of your 
unmodified T cells may be given to you. 
RISKS, STRESS OR DISCOMFORT 
The side effects, and possible risks of this treatment will be discussed for each of the three components of this 
therapy. 
1. Bone Marrow Transplantation 
Cyclophosphamide may cause nausea, vomiting, diarrhea, oral sores (mucositis), temporary hair 
loss, temporary bladder irritation and, at times, bleeding from the bladder. A small portion of 
patients may have prolonged bladder damage and bleeding. Cyclophosphamide also causes decreased 
immunity which may result in increased infections for several months following the transplant. Heart 
damage may occur in a small number of patients. 
Total body irradiation may cause nausea, vomiting, diarrhea, and painful swelling of the parotid 
gland for a few days. Temporary hair loss also occurs. The TBI will destroy both the lymphoma 
and your normal marrow, leading to a disappearance of red blood cells, white blood cells, and 
platelets. To do this, irradiation must be administered in exposures which would be lethal without 
subsequent marrow transplantation. The temporary absence of these blood products produces a risk 
of anemia, infection, and/or bleeding which will persist until your marrow transplant begins to 
function. Blood transfusion will be provided to you as needed. There is a risk that your marrow 
transplant will not function adequately. There is a small risk that the marrow may not properly 
engraft in you. This could lead to serious, perhaps fatal bleeding or infectious complications. You 
might need a second marrow transplant should such graft problems develop. 
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Recombinant DNA Research, Volume 15 
