A Feasibility Study of Prophylactic White Blood Cell Transfusions

Study Procedures:

During each white blood cell transfusion, you will receive white blood cells from a volunteer
donor through a needle in your vein. Each transfusion will take anywhere from 1 hour to
several hours, depending on how you tolerate the treatment. You will receive a transfusion
approximately every 3-4 days (2 a week) for up to 6 weeks.

Before each white blood cell transfusion, your vital signs (temperature, heart rate,
breathing rate, and blood pressure) will be recorded according to standard evaluation of
patients with fever to look for underlying infectious causes. During and for 1 hour after the
transfusion, you will be monitored for side effects. You may be given a drug to help or
reduce any side effects. Your doctor will tell you more about any drug that may be given for
side effects.

If at any point you develop a fever while on study, blood (about 1 teaspoon) and urine will
be collected to check for infection according to standard evaluation of patients with fever
to look for underlying infectious causes. You may also have a chest x-ray. If it is abnormal
or if you have symptoms (cough, shortness of breath, nasal congestion), you may need a
computed tomography (CT) scan of the chest and/or sinuses. That will be done within 3 days of
developing a fever. If the doctor thinks it is needed, you will than have another CT scan 2
weeks later and at any other point that the doctor thinks it are needed to check for
infection.

Length of Study:

You will continue to have transfusions until the doctor thinks infection has been controlled
or until your white blood cell counts stay at a certain level for at least 2 days in a row.
If any point you are discharged from the hospital and your doctor wants you to continue
receiving white blood cell transfusions, you will be able to receive them as an outpatient.

You will be monitored for side effects and signs of infection for up to 6 weeks. You will be
taken off study if you have intolerable side effects.

This is an investigational study. Radiated white blood cell transfusions are considered to be
a standard procedure for the treatment of serious infections. It is investigational to give
unirradiated white blood cell transfusions as a way of preventing infections.

Up to 50 patients will take part in the study. All will be enrolled at MD Anderson.

Inclusion Criteria:

1. All acute myelogenous leukemia and high-risk myelodysplastic leukemia patients who are
admitted to the leukemia service and those who are referred from other services (i.e.
pediatrics, medical oncology, etc.) will be eligible for the study.

2. Patients will be undergoing initial therapy for their disease or undergoing first
salvage treatment, i.e. patients who fail therapy, or respond and relapse after
initial therapy.

3. Patients will be free of signs and symptoms of infection at the time of entering the
study and, most importantly, will be encouraged to have sufficient donors to
administer prophylactic white cell transfusion twice a week for six weeks in order to
assess their effectiveness.

Exclusion Criteria:

1. Patients with baseline (at start leukemia treatment) infection, defined as patients
with a) fever and known positive cultures at the time of registration; or b) chest or
sinus computed tomography with findings suggestive of pneumonia or sinusitis; or c)
one positive galactomannan test >/= 1 or two positive galactomannan text >/= 0.5 to 1.

2. Patients with Zubrod performance status >/= 3.