Monitoring for infectious sequelae in patients with central venous catheters is recommended. Each dose of Sipuleucel-T requires a standard leukapheresis procedure approximately 3 days prior to the infusion. Adverse events that were reported ≤ 1 day following a leukapheresis procedure in ≥ 5% of patients in controlled clinical trials included citrate toxicity (14.2%), oral paresthesia (12.6%), paresthesia (11.4%), and fatigue (8.3%). Table 1 provides the frequency and severity of adverse events reported in ≥ 5% of patients in the Sipuleucel-T group of randomized, controlled trials of men with prostate cancer. T able 1 Incidence of Adverse Events Occurring in ≥ 5% of Patients Randomized to Sipuleucel-T Page 28 of 50 IRB Protocol No. 12367 Version Date: 10/24/2017 Version: 09 Sipuleucel -T (N = 601) Control* (N = 303) All Grades n (%) Grade 3 -5 n (%) AG All Grades n (%) Grade 3 -5 n (%) Any Adverse Event 591 (98.3) 186 (30.9) 291 (96.0) 97 (32.0) Chills 319 (53.1) 13 (2.2) 33 (10.9) 0 (0.0) Fatigue 247 (41.1) 6 (1.0) 105 (34.7) 4 (1.3) Fever 188 (31.3) 6 (1.0) 29 (9.6) 3 (1.0) Back pain 178 (29.6) 18 (3.0) 87 (28.7) 9 (3.0) Nausea 129 (21.5) 3 (0.5) 45 (14.9) 0 (0.0) Joint ache 118 (19.6) 11 (1.8) 62 (20.5) 5 (1.7) Headache 109 (18.1) 4 (0.7) 20 (6.6) 0 (0.0) Citrate toxicity 89 (14.8) 0 (0.0) 43 (14.2) 0 (0.0) Paresthesia 85 (14 .1) 1 (0.2) 43 (14.2) 0 (0.0) Vomiting 80 (13.3) 2 (0.3) 23 (7.6) 0 (0.0) Anemia 75 (12.5) 11 (1.8) 34 (11.2) 7 (2.3) Constipation 74 (12.3) 1 (0.2) 40 (13.2) 3 (1.0) Pain 74 (12.3) 7 (1.2) 20 (6.6) 3 (1.0) Paresthesia oral 74 (12.3) 0 (0.0) 43 (14.2) 0 (0.0) Pain in extremity 73 (12.1) 5 (0.8) 40 (13.2) 1 (0.3) Dizziness 71 (11.8) 2 (0.3) 34 (11.2) 0 (0.0) Muscle ache 71 (11.8) 3 (0.5) 17 (5.6) 0 (0.0) Asthenia 65 (10.8) 6 (1.0) 20 (6.6) 2 (0.7) Diarrhea 60 (10.0) 1 (0.2) 34 (11.2) 3 (1.0) Influenza -like illness 58 (9.7) 0 (0.0) 11 (3.6) 0 (0.0) Musculoskeletal pain 54 (9.0) 3 (0.5) 31 (10.2) 3 (1.0) Dyspnea 52 (8.7) 11 (1.8) 14 (4.6) 3 (1.0) Edema peripheral 50 (8.3) 1 (0.2) 31 (10.2) 1 (0.3) Hot flush 49 (8.2) 2 (0.3) 29 (9.6) 1 (0.3) Hematuria 46 (7.7) 6 (1.0) 18 (5.9) 3 (1.0) Muscle spasms 46 (7.7) 2 (0.3) 17 (5.6) 0 (0.0) Page 29 of 50 IRB Protocol No. 12367 Version Date: 10/24/2017 Version: 09 8.2 Radiation therapy 8.2.1 Treatment Plan: In patients assigned to Arm B one metastatic site will be selected for radiation based primarily on the safety of radiation in that location. Radiation to bone metastases in L3-S5, pelvis and femurs will be excluded provided that patients have other areas of metastases. Patients who have metastases only in the above locations (L3-S5, pelvis and femurs) will be allowed provided that they have normal WBC and they will not receive radiation to more than 20% of the bone marrow. The gross tumor volume (GTV) will be defined as the radiological dimensions of the lesion as identified by CT and/or MRI. The planning tumor volume (PTV) is defined as the GTV plus 1 cm. For lesions that move with respiration (Rib and lung parenchymal lesions for example) CT simulation will be performed at inspiration and expiration to define lesion position during the respiratory cycle. The GTV will be defined based on lesion position during the respiratory cycle. Radiation treatment fields will arranged to minimize dose to the marrow and whole body. Conventional AP/PA technique will be used. Field will be limited to 10 by 10 cm.Patients will be treated with 300 cGy/day to 3000 cGy; Approximately 7 days after completion of radiation therapy, patients will begin therapy with Sipuleucel-T autologous vaccine. 8.2.2 Toxicity: The risks of radiation therapy depend on the part of the body being treated. These side effects are generally mild and expected to resolve 1-2 weeks after radiation is completed: -fatigue, -anorexia -gastroesophageal reflux -diarrhea -nausea -dysuria -urinary frequency -pain flare -skin rash, -neutropenia, -thrombocytopenia, -anemia Long term effects of radiation also depend on the specific location being treated and include: - pneumonitis - cystitis - hematuria - secondary malignancy - chronic diarrhea - bowel perforation Page 30 of 50 IRB Protocol No. 12367 Version Date: 10/24/2017 Version: 09 9.0 Correlative/Special Studies Blood collection must be scheduled Monday to Thursday to allow for overnight shipping to be received by Friday.