methotrexate (as above) post transplantation when WBC >2. Ox 10 9 /L and 
platelets >75 x 10 9 /L. These 5 LPs will be performed over Vh. to 4 weeks. 
Citrovorum will be given 5 mg PO (or IV) every 6 hours x 4 starting 24 hours 
post IT MTX. If arachnoiditis develops, all IT MTX will be given with 20 mg 
of IT hydrocortisone. 
11.4 BU (busulfan) = 4 mg/kg/day (total 16 mg/kg). Daily dose divided into 
every 6 hour oral doses (1 mg/kg every 6 hours). Pills (2 mg) may be 
enclosed up to 8 per gelatin capsule (16 mg). 
DILANTIN : Since generalized seizures have been reported with high dose 
busulfan, patients will receive prophylactic dilantin 5 mg/kg/dose (IV or PO) 
q 6 hr starting day -10 for 48 hr (8 doses) then 5 mg/kg daily until day -4. 
CTX (cyclophosphamide) = 50 mg/kg IV on each of four successive days. 
Hematuria is not uncommon at this dose level of cytoxan. Adequate urine 
flow is essential and the exact hydration and MESNA doses should be 
followed. Please see agent information section VI and preprinted order 
sheets. 
11.5 Marrow Infusion 
At the time of autologous marrow reinfusion (day 0), the LNL-6 and GIN 
purged bone marrow suspension will be rapidly thawed in a 37° water bath 
and each bag rapidly infused through a central venous catheter. 
11.5.1 Marrow to be infused will arrive on the unit hand-carried by the 
transplant coordinator. 
NOTE: Marrow DOES NOT receive IRRADIATION . 
11.5.2 Preparation of the patient 
a. Oxygen and suction equipment MUST be set up in room. 
b. Emergency drugs BENADRYL, EPINEPHRINE, 
SOLUMEDROL OR SOLUCORTEF in appropriate doses 
must be ordered by the physician prior to initiation of infusion 
and be available at the bedside. See preprinted order sheets 
for marrow reinfusion. 
c. Procedure is explained to the patient and family. 
Recombinant DNA Research, Volume 17 
