Patients with a history of CNS disease at any time in the past (including 
immediately pre-transplant) will also receive 5 lumbar punctures with IT 
methotrexate (as above) post transplantation when WBC >2.0 x 10^/L and 
platelets >75 x 10^/L. These 5 LPs will be performed over 2h to 4 weeks. 
Citrovorum will be given 5 mg PO (or IV) every 6 hours x 4 starting 24 hours 
post IT MTX. If arachnoiditis develops, all IT MTX will be given with 20 mg, 
of IT hydrocortisone. 
11.3 BU (busulfan) = 4 mg/kg/day (total 16 mg/kg). Daily dose divided into every 
6 hour oral doses (1 mg^g every 6 hours). Pills (2 mg) may be enclosed up 
to 8 per gelatin capsule (16 mg). 
Since generalized seizures have been reported with high dose busulfan, 
patients will receive prophylactic dilantin 5 mg/kg/dose (IV or PO) q 6 hr 
starting day -10 for 48 hr (8 doses) then 5 mg/kg daily until day -4. 
CTX (cyclophosphamide) = 50 mg/kg IV on each of four successive days. 
Hematuria is not uncommon at this dose level of cytoxan. Adequate urine 
flow is essential and the exact hydration and M^NA doses should be 
followed. Please see agent information section VI and preprinted order 
sheets. 
11.4 Marrow Infusion 
At the time of autologous marrow reinfusion (day 0), the frozen untreated or 
LNL-6 treated bone marrow suspension will be rapidly thawed in a 37 " water 
bath and rapidly infused through a central venous catheter as detailed. 
1. Marrow to be infused will arrive on the unit hand-carried by the 
transplant coordinator. 
NOTE: Marrow DOES NOT receive IRRADIATION . 
2. Preparation of the patient 
a. Oxygen and suction equipment MUST be set up in room. 
b. Emergency drugs BENADRYL, EPINEPHERINE, 
SOLUMEDROL OR SOLUCORTEF in appropriate doses 
must be ordered by the physician prior to initiation of infusion 
Recombinant DNA Research, Volume 14 
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