MEDICAL RECORD 
CONTINUATION SHEET for either: 
NIH 2514-1, Consent to Participate In A Clinical Research Study 
NIH 2514-2, Minor Patient s Assent to Participate In A Clinical Research Study 
STUDY NUMBER: 
CONTINUATION: page JL_ of 11 
Post-transplant G-CSF will be given intravenously daily, 
until adequate levels of white blood cells are reached. 
Patients who show a high level of toxicity thought to be 
related to the G-CSF will have their dose reduced and if 
toxicity persists the G-CSF will be discontinued. See 
section 3) for further information on G-CSF. 
For the first part of your treatment after the 
transplantation (approximately 25-40 days), you will be 
cared for in the hospital. You will be highly prone to 
infections due to a very low white blood cell count. Your 
visitors will be screened for any possible infections and 
will need to exercise precautions against infections (such 
as good hand washing and .wearing a mask) before they visit 
you. Young children will be discouraged from visiting you. 
- While you are in the hospital you will stay in a isolation 
room and receive a diet which excludes raw food. 
Precautions will be taken to try to protect you from 
developing infections and thus you will be placed on 
numerous types of medications and antibiotics. You will 
receive supportive care such as blood transfusions (red 
blood cells and platelets) in order to counteract to the 
greatest possible extent the possible complications of your 
therapy. 
Throughout the transplant process, your physical condition 
will be monitored closely in order to avoid severe side 
effects. We will draw blood daily, and routinely collect 
urine, stool, and sputum to test them for infection and for 
their normal components. X-rays will also be done regularly 
to try and detect infections. You will have bone marrow 
samples taken from your hip through aspiration every week 
until your marrow recovers. This will be done at the 
bedside with local anethesia. 
CvclophosphaTni da will cause low blood counts, and hair loss, 
and may cause kidney damage, loss of appetite, nausea and 
vomiting, mouth sores, metallic taste, headache, rash, 
facial blushing, and hemorrhagic cystitis (inflammation and 
bleeding of the bladder). More rarely it can cause heart, 
lung or liver damage. 
PATIENT IDENTIFICATION 
CONTINUATION SHEET for either: 
[188] 
Recombinant DNA Research, Volume 16 
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