Long term Follow Up 
As with all patients with leukemia treated at this Hospital, we aim to follow your/your child’s 
progress over a long period. You/^our child will need to be examined yearly for 14 years 
after the transplant. At this time a teaspoon of blood will be taken. 
Side Effects 
The drugs to be given in this study will produce unwanted side effects. Doctors will closely 
observe your/your child’s condition throughout the course of therapy in an effort to prevent 
or reduce the severity of these effects. YouA^our child will receive a drug called Mesna to 
prevent bleeding from the bladder, and dilantin to stop possible seizures. Bone marrow 
transfusion can also produce complications that could be life-threatening. The busulfan and 
Cytoxan given in this treatment will destroy normal bone marrow and cause severe infections 
and bleeding. All patients will need antibiotics, blood transfusions and possibly a medication 
called amphotericin B for fungal infections. By experience at other centers 1 of 10 children 
treated in this way will not develop effective blood production despite receiving the treated 
marrow (graft failure). A second marrow may be given on day 35 to 40 after the first 
marrow infusion to restore blood production if graft failure occurs. The table below lists the 
short- and long-term side effects of these agents. 
Agent Possible side effects 
Busulfan Permanent damage to bone marrow 
Increased skin pigmentation 
Lung disease 
Skin rash 
Liver damage 
Inability to have children (sterility) 
Breast growth in males 
Cataracts 
Second cancers 
Seizures 
Cytoxan Severe nausea and vomiting 
Electrolyte imbalance and fluid retention 
Diarrhea 
Bleeding from the bladder 
Hair loss 
Skin rashes 
Low blood counts 
Sterility 
Heart failure 
Methotrexate Headaches 
(Injected in the Nausea, vomiting 
spinal fluid Seizures 
Brain damage 
Back pain 
Recombinant DNA Research, Volume 14 
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