the machines in the FHCRC pheresis unit and take approximately 4 hours. The peripheral blood cells 
will be frozen and stored along with your marrow. To test your body’s response to the treatment, 10 
daily samples (2 teaspoons each) of blood will be drawn beginning just prior to the first dose of rhG- 
CSF. 
After you have received the appropriate preparative regimen, your marrow and then your peripheral 
blood cells will be infused. Within 2 hours of completing the infusions you will receive rhG-CSF which 
will continue through day 20. 
RISKS, STRESS OR DISCOMFORT 
Few complications have been reported and they have involved minor problems with the Hickman 
catheter and minor toxicities of rhG-CSF. However, this study involves certain theoretical risks, 
described below. 
Bleeding - Because we do not wish the blood to clot in the tubing, it is necessary to add a drug called 
heparin to the blood. This reduces the ability of the blood to clot and introduces an element of risk. 
Heparin in much lower concentrations is a normal constituent of blood. 
Infection - The risk of infection always exists when a person’s blood is circulated outside the body. The 
risk involved is small. Donprs frequently ask whether the removal pf. large numbers of white cells by 
this procedure renders them at greater risk of developing infection. As explained above, all these cells 
are replaced about three times each day in a normal person, and in addition there are very large 
reserves of these cells stored outside the blood in the body. It has been found that the donor’s white 
cell count after the procedure is usually the same as before. To decrease the infection risk, all donors 
are given a 10 day course of prophylactic antibiotics following surgical placement of the Hickman 
catheter. 
Hickman Catheters - There has been considerable experience with the use of Hickman catheters in 
patients requiring chemotherapy and long-term hyperalimentation and more recently in donors giving 
granulocytes. The complications have been clotting and local infection. Clotting may necessitate 
discontinuance of catheter use or removal of the clot by a fibrinolytic agent (Urokinase). There is 
much experience here in the care of Hickman catheters. Occasionally, there has been local 
inflammation at the catheter exit site, and additional antibiotics may be necessary. 
Anemia - Although the majority of the red blood cells are returned to the donor, some cells are 
removed with each collection. If the donor become anemic after a series of collections, a blood 
transfusion will be given or no further collections will be made. 
Risks related to rhG-CSF - Human and animal data suggest that rhG-CSF is well tolerated. It may, 
however, cause temporary mild to moderate muscle and bone pains during the time of treatment. 
Occasional worsening of inflammatory conditions such as psoriasis and vasculitis have been observed. 
Some patients experience fever, headache or myalgia with this treatment. There may also be a 
temporary elevation of leukocyte alkaline phosphatase, lactate dehydrogenase and uric acid. The 
increase of these laboratory values reflects the increase of white blood cells caused by the rhG-CSF and 
these laboratory values return to normal within one week of discontinuing rhG-CSF treatment, 
patients. There may also be toxicities of rhG-CSF which are not yet apparent, including long-term 
toxicities. 
Recombinant DNA Research, Volume 16 
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