b. Once antibiotic treatment has been initiated, it will not be routinely 
discontinued until marrow function has been restored, even if clinical 
evidence of infection, i.e., fever, has resolved. 
c. Special emphasis will be placed on evaluation of infection at sanctuary 
sites such as the sinuses. 
d. Antifungal treatment will be considered in febrile patients who have 
had 7-10 days of broad spectrum IV antimicrobials. Patients may be 
enrolled on open SJCRH infectious disease protocol for treatment. 
e. High index of suspicion is necessary for evaluation and treatment of 
interstitial pneumonitis in the post-BMT patient. Patients with low- 
grade fever and chronic cough should have prompt chest x-ray and 
pulmonary evaluation. FVC will be obtained two times a week for the 
first three weeks post-BMT and oximeter studies will be employed as 
necessary. Patients with pulmonary infiltrates will be placed on the 
Pneumopathy X protocol. 
f. To prevent activation of pneumocystis carinii (PCP) all patients will 
receive oral prophylaxis with trimethoprim (150 mg/mVday) plus 
sulfamethoxazole (750 mg/m^/day) in two equally divided doses on 
Monday, Tuesday and Wednesday. 
13.0 EVALUATION DURING THERAPY 
13.1 Pre-Transplant 
1 . History - complete history of previous antineoplastics, radiation therapy, 
infections, and transfusions 
2. Complete physical examination 
3. Laboratory screen 
a. CBC, differential, platelet estimate 
b. Electrolytes, BUN, creatinine, SGOT, SGPT, gamma GT, total 
bilirubin, total protein, albumin, alkaline phosphatase 
c. Urinalysis 
d. Chest x-ray 
e. Echocardiogram and EKG 
f. CPK, LDH isoenzymes 
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Recombinant DNA Research, Volume 14 
