the your clinical condition. Special studies involving blood drawing for specific research studies are 
described in the appropriate consent forms. 
RISKS, STRESS, OR DISCOMFORT 
Cyclophosphamide may cause nausea, vomiting, diarrhea, temporary bladder irritation, and, at times, 
bleeding from the bladder, and temporary hair loss. A small portion of patients may have prolonged 
bladder damage and bleeding. Cyclophosphamide also suppresses production of red blood cells, white 
blood cells, and platelets, causing a risk of infection and/or hemorrhage until the graft begins to 
function. Cyclophosphamide causes decreased immunity which may also lead to increased infections for 
several months following transplant. Heart damage may occur in a small number of patients. 
Cyclophosphamide may result in sterility. Even if sterility does not occur, there is a major risk of 
genetic damage to any future offspring. There may be some as yet unknown consequences to the 
patients health resulting from the administration of cyclophosphamide. 
Total Body Irradiation may cause nausea vomiting diarrhea and painful swelling of the parotid gland (a 
gland under the chin) for a few days. Temporary hair loss also occurs. The TBI will also destroy both 
the abnormal and normal marrow, leading to a disappearance of red blood cells, white blood cells, and 
platelets. The temporary absence of these blood products produces a risk of anemia, infection, and/or. 
bleeding which will persist until the bone marrow transplant begins to function. Blood transfusions will 
be provided as needed. There is a risk that cataracts may develop in the eyes (an opacity or whitening 
of the lens) which results in partial loss of vision which may require contact lens or surgery to remove 
the cataracts. The irradiation dose used will probably result in sterility. Even if sterility does not occur, 
there is a major risk of genetic damage to any future offspring. There may be some as yet unknown 
consequences to the patients health resulting from the administration of total body irradiation. 
Busulfan. The immediate effects of busulfan may include vomiting, diarrhea, and seizures. Medication 
will be given to minimize or prevent these side effects. The late effects which are usually temporary 
may include hair loss and hyperpigmentation (changes in skin color). Some patients may develop a 
rash. Some patients may develop mucositis (mouth sores). Some patients may develop abnormal 
function of the liver or lung. 
Marrow Transplant. There is a risk of increased infections or even death prior to engraftment or in 
the event your marrow does not function adequately after engraftment. Blood counts will be done 
frequently to monitor the return of marrow function. Platelet and red cell transfusions will be given as 
necessary to maintain adequate levels. There is a risk that the peripheral blood stem cell graft may not 
grow. Such a graft failure might be fatal unless a second transplant could be carried out. In this event 
marrow would be harvested from your twin donor between 20 and 30 days after transplant. 
The risks of transplant are extensive and include the possibility of life-threatening infection, bleeding, or 
organ damage leading to death. 
BENEFITS 
The benefits to you will be a faster graft if peripheral blood stem cells result in more rapid recovery of 
blood counts. This would result in earlier discharge from the hospital and a potential for fewer 
infections or bleeding complications. 
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Recombinant DNA Research, Volume 16 
