MEDICAL RECORD 
STUDY NUMBER: 
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 
.CONTINUATION: page of _14 pages 
8) Post-transplant Interferon treatment will be given to 
attempt to suppress any remaining leukemic cells. The drug 
will be given subcutaneously three time per week once the 
blood counts have recovered sufficiently from the transplant 
procedure. The interferon dosage will be adjusted or 
discontinued if toxicity develops. See section 1) for 
further information. 
In addition, with any experimental therapy it is possible 
that harmful side effects that are currently unknown could occur. 
We will, of course, take every precaution to watch for and 
prevent harmful side effects. 
If you are pregnant we want you to tell us and we will not 
include you in this study because to do so might be harmful to 
your unborn baby. We also want you to avoid getting pregnant 
during this study and expect you to use an effective method of 
birth control. If you should become pregnant in spite of taking 
precautions please contact the primary investigator whose phone 
number is listed in this form and she will discuss with you the 
choices that are available for you to consider. The very high 
dose chemotherapy and radiation treatments used in this protocol 
are very likely to prevent you from having children in the 
future, or could cause birth defects in any children you are able 
to conceive. 
If you die before receiving your bone marrow and peripheral 
blood stem cells back, the cells will become the property of the 
National Institutes of Health and will be used for research 
purposes to try and learn more about leukemia. Because you will 
have been part of a research study at NIH, if you die at any time 
during or after the study, your family or a designated power of 
attorney will be contacted about permission to do a post-mortem 
examination. This consent form does not imply you or your 
family's consent to a post-mortem examination, but should serve 
as a stimulus for discussion of the issue between you, your 
family and your doctors. 
Benefits 
The benefit of participation in this study is the potential 
for prolongation of life and cure of your leukemia. You will 
also be aiding medical science and society at large as this study 
PATIENT IDENTIFICATION 
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CPO »l I 
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CONTINUATION SHEET for either: 
Recombinant DNA Research, Volume 16 
