V. TBI and cytoxan therapy. 
VI. Infusion of autologous marrow and study with PCR 
for immunoglobulin gene rearrangement and Neo on 
thawed specimen before infusion. 
VII. PCR for Neo immunoglobulin gene rearrangement 
after ANC of 2000/mm 3 is achieved. 
VIII. PCR for immunoglobulin gene rearrangement and 
neo at 3-4 weekly intervals during and after 
recovery for the first 6 months, and thereafter 
at 6 monthly intervals for 4 years and at the 
time of relapse. 
IX. Interferon maintenance therapy after ANC of 
2000/mm 3 and platelet count of 100,000/mm 3 . 
6.0 EVALUATION DURING STUDY (SEE APPENDIX I) 
6.1 A complete history and physical examination including 
documentation of all measurable disease, especially 
spleen and liver size, signs and symptoms, 
performance status and weight loss. A dental 
examination is also recommended. 
6.2 Laboratory studies include CBC, platelet count, 
differential, SMA 12, liver and renal function tests, 
coagulation studies (PT, PTT, Fibrinogen, FSP) , viral 
serology and cytogenetics. Southern analysis will be 
conducted on the same samples. 
6.3 Peripheral blood and bone marrow aspirate and biopsy 
for morphology, pathology, cytogenetics, and PCR. 
6.4 An EKG and CXR will be performed on all patients. An 
echocardiogram or an MVGA will be done. A urinalysis 
will also be obtained before therapy. 
6.5 Pulmonary function studies with diffusion capacity 
will be done. 
7.0 EVALUATION DURING STUDY (SEE APPENDIX I) 
7.1 CBC, platelet, differential every 1-2 days during the 
initial induction. 
7 . 2 SMA 12 , lytes every three to seven days and as 
indicated additionally. 
7.3 Bone marrow aspirate and biopsy for morphologic 
pathology, cytogenetics, FISH, and PCR should be 
performed at marrow recovery (when WBC count > 2.0 
K/ul) . 
7.4 Upon marrow recovery, a full work-up including CBC, 
platelet count and differential, SMA 12, and marrow 
studies including cytogenetics will be performed 
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