-5 or earlier:' Bone marrow harvest. 
-5 Begin pentoxifylline 1600 mg/day po divided qid. 
. Continue until day +30. 
-2 Begin IV fluid hydration at 100-150 cc/hr. 
Supplemental potassium and magnesium may be added 
as necessary, and bicarbonate infusion and 
allopurinol may be given in the rare patient at 
high risk for tumor lysis syndrome. 
-1 Melphalan 200 mg/m 2 X 1 over 60 minutes IV (see 
appendix for detailed drug information) . Patients 
greater than 20% over their ideal body weight will 
have their dose adjusted to: ideal weight + 
(actual weight - ideal weight/ 2) . 
0 Autologous marrow and peripheral blood stem cell 
reinfusion: Cells are infused intravenously at 
the bedside over 30-120 minutes without a filter 
after rapid thawing in a 37 degree water bath. 
Total volume expected to be 100-500 cc. Possible 
toxicities include volume overload, which can be 
treated by slowing the infusion and using 
diuretics, and transient dyspnea due to mast cell 
degranulation induced by DMSO, which can be 
treated with antihistamines. 
+1 Begin granulocyte-macrophage colony-stimulating 
factor (G-CSF) 12 ug/kg/day as an intravenous 
bolus, continue until absolute neutrophil count 
reaches 1000/mm 3 for three consecutive days, or 
day 28. If the ANC falls to < 500/ul after 
discontinuation, restart at prior dose, (see 
appendix for detailed drug information) See 
section 11.0 for dose modifications. 
5v 7 Pbst-Engraftment Maintenance Interferon Therapy 
When the absolute' neutrophil' count is > 1500/ul 
maintained .of f of G-CSF for greater than one week and 
■ the platelet count is > 80,000/ul, recombinant alpha 
interferon at a. dose, of 3 X 10-6 units/m2 
subcutaneously 3X/week will be started and continued 
until relapse, unacceptable toxicity or > 2 years of 
continuous CR.. See. section 11.0 for. dose modifications. 
6.0 CONCURRENT TREATMENT AND SUPPORTIVE CARE 
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Recombinant DNA Research, Volume 16 
