Methotrexate is administered intrathecally (into the spinal column) in an effort to prevent recurrence 
of lymphoma in the central nervous system. Intrathecal injections may result in nausea and/or 
vomiting in some patients. The combination of total body irradiation and methotrexate administered 
intrathecally (into the spinal column) may lead to severe central nervous symptoms in a very small 
number of patients. The risk of this complication is highest for patients who have had previous 
central nervous system therapy and/or disease. This complication can lead to brain damage, lasting 
paralysis and even death. 
ADDITIONAL RISKS 
a) There is a possibility that your lymphoma may recur even if the transplant is successful. 
b) In addition to the above risks, there is a risk of organ failure, including heart, kidney, lung, 
brain, liver, or other body parts. This risk is increased if you have already had significant 
chemotherapy and/or radiation therapy. 
c) There is a risk that cataracts may develop in your eye(s). 
d) The irradiation dose used will probably result in sterility. Even if sterility does not occur, 
there is a major risk of genetic damage to any future offspring of yours. 
e) As with any chemotherapy administration, in drawing blood samples the insertion of the 
needle may cause temporary discomfort and a bruise may form at the point where the needle 
enters the vein. Painful oral sores (mucositis) develop after cyclophosphamide and TBI but 
generally resolve with return of adequate white blood cell counts. 
f) There may be some as yet unknown consequences to you (or your embryo or fetus should you 
become pregnant) from the use of TBI, cyclophosphamide, methotrexate treatments, and/or 
other procedures outlined here. 
The complications of BMT, including infections, visual impairment and seizures may be worse 
because of HIV-1 infection. In addition, there is the possibility that the HIV infection may be worse 
because of the transplant. 
2. Zidovudine Administration 
Zidovudine (AZT) may cause headaches, suppression of white blood cells, and suppression of red 
blood cells (anemia). Rash, fever, tremor and changes in mental function have also been reported 
which resolve with discontinuation of the drug. In lab animals, liver and kidney toxicity has been 
observed at very high doses. In addition, a limitation of Zidovudine (AZT) is that it may have to be 
taken indefinitely in order to prevent re-infection of the new marrow cells by HIV-1. If the drug has 
to be discontinued because of life-threatening toxicities, or because you fail to take the medication on 
the prescribed basis, the new marrow is at increased risk for HIV-1 reinfection. It is not known if 
Zidovudine (AZT) will have adverse effects on this BMT process, or if it will possibly prevent 
engraftment of the donor marrow (if this occurs, the outcome is potentially fatal). 
3. Adoptive Immunotherapy with Genetically Modified HIV-specific T Lymphocytes 
Large doses of highly activated lymphocytes have been given intravenously to cancer patients as a 
form of cancer therapy with no severe toxicities attributed to the T cell infusions. Minor toxicities 
have been observed and include: fever and chills in the majority of patients, headaches and nausea in 
a minority of patients. At our center, we have administered lymphocytes specific for cytomegalovirus 
to patients following bone marrow transplant. There were no toxicities observed in these patients and 
the infusions could be given in the outpatient department. However, it is possible that HIV-specific 
lymphocytes could cause side effects if they induce severe inflammation in organs such as the brain or 
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