undergo transplantation. If less than 0.5 X 10 8 nucleated 
cells/kg are .obtained, then no high-dose chemotherapy or 
autotransplantation will be attempted: If deemed appropriate 
by the principal investigator, a second marrow harvest may 
be attempted in order to obtain adequate numbers of cel.ls. 
4.10 Peripheral blood nucleated cell harvest of > 3 X 
10 8 /kg. 
4.11 Patients maintained on interferon or chemotherapy will 
have these treatments discontinued for at least four weeks 
prior to entry into this study. 
4.12 Ability to give informed consent. 
5 . 0 TREATMENT PLAN 
5.1 Placement of Central Venous Catheter 
All patients will have a double or triple lumen semi- 
permanent silastic central venous catheter of an 
adequate size to allow apheresis placed in the 
operating room prior to initiation of pre-apheresis 
cyclophosphamide. The Davol hemodialysis Hickman 
catheter would be preferred. General or local 
anesthesia may be used. 
5.2 Peripheral Blood Stem Cell Mobilization and Harvest 
See section 7.1 for details of apheresis procedures. 
Throughout patients will receive standard antiemetic 
regimens as required, and intravenous hydration to 
maintain good urine output and normalize electrolytes. 
Prior chemotherapy or interferon will be discontinued 
at least 28. days before beginning this treatment plan. 
Day # 
Day 1 Begin intravenous hydration 2 liters/m 2 /day 
normal saline. Continue X 24 hours. If urine output is 
less than 100 cc/hr, consider furosemide. 
At least 2 hours after beginning hydration, give 
cyclophosphamide 4 grams/m 2 . IV over 60 minutes. (see 
appendix 'for detailed drug information) 
Recombinant DNA Research, Volume 16 
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