1. Volume overload: This can be avoided by 
administering small doses of furosemide to keep 
urine output > lOOcc/h. This is of particular 
importance in small recipients who have previously 
received blood or platelet transfusions, but will 
probably not be necessary in this patient 
population. 
2. Transient dyspnea: Usually not a problem but . 
occurs due to a tendency of DMSO to degranulate 
mast cells and cause allergic reactions. 
3. Allergic reactions: Chills, fever, and hives 
occasionally occur. These reactions are usually 
not severe and respond to parenteral benadryl. 
Premedication with benadryl and hydrocortisone is 
appropriate. 
5.6 Post-transplant G-CSF 
G-CSF 12 ug/kg IV over 2 hours to begin three hours 
after marrow/PBSC infusion, then daily until the ANC 
exceeds 1000/mm3 on three consecutive days or a planned 
duration of 28 days. 
5.7 Post-transplant interferon maintenance 
Interferon alpha (Roferon) at a dosage of 5 x 10 6 
IU/m 2 /day subcutaneously three times per week when the 
platelet count exceeds 50,000/mm 3 and ANC exceeds 
2 , 000/mm3 . 
6.0 Concurrent and Supportive Care 
6.1 Central Venous Catheter Placement 
All patients will have large bore double lumen central 
catheters suitable for apheresis placed preferably at 
least one to two weeks prior to cytoreductive 
chemotherapy or the transplant conditioning regimen. 
Patients who are harvested with plans to delay 
transplant indefinitely will have the large bore 
catheters removed after stem cell collection. 
6.2 Platelet Transfusions 
1. Indications: Platelets are transfused to prevent 
bleeding and an attempt is made to keep the 
circulating platelet level at least 20,000/mm3 at 
all times. 
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Recombinant DNA Research, Volume 16 
