Introduction: Low risk, curative therapy for patients with multiple myeloma remains elusive. Autologous stem cell transplant remains the standard of care for newly diagnosed multiple myeloma. Mobilization of adequate CD34+ cells can be a difficult task, especially in patients who have been heavily pretreated. We have compared the three mobilization regimens utilized at our facility and the subsequent CD34+ collections. Background: Standard chemotherapy is effective in maintaining control of multiple myeloma, however none has proven curative. Several trials have indicated that tandem or double autologous transplants may provide a significant benefit for overall survival and event free survival. When double transplants are planned, especially for patients who are heavily pretreated, collection of adequate CD34+ cells can prove to be challenging. Methods: 217 patients with multiple myeloma whose treatment plan included either a single or double autologous transplant were evaluated retrospectively. Data have been collected from January 1999 to March 2005. Mobilization regimens utilized were etoposide/cyclophosphamide+GCSF, 60 patients; cyclophosphamide+GCSF, 34 patients; and GCSF alone, 123 patients. Peripheral blood stem cells were collected following standard institutional procedures utilizing the Cobe Spectra apheresis machine. Standard CD34+ cell dose target for a single transplant was >2.0 × 106/kg. Results: Average and median CD34+ cell dose collected for patients receiving GCSF alone was 24.05 × 106/kg and 6.3 × 106/kg; cyclophosphamide+GCSF 13.28 × 106/kg and 9.75 × 106/kg; etoposide/cyclophosphamide+GCSF 39.98 × 106/kg and 30.4 × 106/kg. The average number of collections required for each regimen was 2.11 days for GCSF, 1.76 days for cyclophosphamide+GCSF, and 1.4 days for etoposide/cyclophosphamide+ GCSF. Conclusions: Etoposide/cyclophosphamide+GCSF mobilization regimen is highly effective in mobilizing large numbers of CD34+ cells in multiple myeloma patients making double or tandem transplants a viable treatment option. Introduction: Low risk, curative therapy for patients with multiple myeloma remains elusive. Autologous stem cell transplant remains the standard of care for newly diagnosed multiple myeloma. Mobilization of adequate CD34+ cells can be a difficult task, especially in patients who have been heavily pretreated. We have compared the three mobilization regimens utilized at our facility and the subsequent CD34+ collections. Background: Standard chemotherapy is effective in maintaining control of multiple myeloma, however none has proven curative. Several trials have indicated that tandem or double autologous transplants may provide a significant benefit for overall survival and event free survival. When double transplants are planned, especially for patients who are heavily pretreated, collection of adequate CD34+ cells can prove to be challenging. Methods: 217 patients with multiple myeloma whose treatment plan included either a single or double autologous transplant were evaluated retrospectively. Data have been collected from January 1999 to March 2005. Mobilization regimens utilized were etoposide/cyclophosphamide+GCSF, 60 patients; cyclophosphamide+GCSF, 34 patients; and GCSF alone, 123 patients. Peripheral blood stem cells were collected following standard institutional procedures utilizing the Cobe Spectra apheresis machine. Standard CD34+ cell dose target for a single transplant was >2.0 × 106/kg. Results: Average and median CD34+ cell dose collected for patients receiving GCSF alone was 24.05 × 106/kg and 6.3 × 106/kg; cyclophosphamide+GCSF 13.28 × 106/kg and 9.75 × 106/kg; etoposide/cyclophosphamide+GCSF 39.98 × 106/kg and 30.4 × 106/kg. The average number of collections required for each regimen was 2.11 days for GCSF, 1.76 days for cyclophosphamide+GCSF, and 1.4 days for etoposide/cyclophosphamide+ GCSF. Conclusions: Etoposide/cyclophosphamide+GCSF mobilization regimen is highly effective in mobilizing large numbers of CD34+ cells in multiple myeloma patients making double or tandem transplants a viable treatment option.

Poster Presentations -Session II confirmation in a randomized trial is needed it appears that Ambi-some® 1 mg/kg/d is an efficacious and cost-effective approach to empiric antifungal therapy in patients with prolonged neutropenia and fever. 247

Poster Presentations -Session II transplantation (SCT) for lymphomas and the engraftment of donor immnnocompetent cells is essential.The height of host "immunological barrier" belongs to the major factors influencing engraftment.Some patients transplanted after non myeloablative regimens finally reconstituted their own immunocompetent cells because of insufficient immunosuppression and there has been no room for GvL effect.On the other hand, many pretrcated immunocompromised recipients developed severe complications due to unnecessary toxicity.11 patients with non-hodgkin lym pbomas (NHL -8x) and chronic lymphatic leukemia (CLL -3x) underwent non-myeloablative allogeneie SCT fronl sibling donor.No one of them was in complete remision (CR) before SCT.The recipients with the pretransplant level of CD3+ cells below than 0, 5x10 9/L were grafted after conditioning combined flndarabin (125rag/m2) and cyclophosphamide (120mg/kg).Those ones with CD3+ cells above 0, 5x10 9/L underwent SCT after fludarabin and melphalan (140rag/m2), fludarabin, melphalan and ATG (40mg/kg)or fludarabin, cyclophosphamide and ATG.The "graft versus host disease" (GvHD) prophyla~s consisted of cyclosporine A (CsA) only or CsA combined with the short-course of methotrexate (MTX).Donor chilnerism was evaluated in T-cell population at day +30, +60, +100 after SCT.CsA tapering depended on the grade of donor chimerism in T-cells. 10 patients (90, 0%) achieved complete donor chimerism in T-cells and sustained CR of their disease at the posttransplant follow-up period (median 134 days).6 recipient (54, 5%) developed GvHD.3 patients (27, 3%) died of transplant-related complications.The combination of fludarabin and cyclophosphamide (+/-ATG) was associated with significantly lower to, city and allowed sufficient engraftment of donor cells with effective immunological mmour control in severe immunocompromised hosts.The reduction of conditioningorelated to,city without the decrease of CR rate fully advocate the pretransplant evaluation of T-cell populations in recipients.

A field study was conducted to determine the effects of gypsum and phosphogypsum on methane and nitrous oxide evolution and on 15N and 226Ra uptake by Oryza sativa L. (rice). Gypsum and phosphogypsum at 2.5, 5.0 and 10.0 tons ha−1 and 15N labelled urea (150 kg N ha−1) were applied pre-flood to experimental plots drill-seeded with `cypress', a semi-dwarf long-grain rice cultivar. Methane and nitrous oxide were measured twice a week over the main cropping season. Plant samples were collected at harvest and 15N uptake and 226Ra activity measured. Three rates of gypsum reduced methane evolution 49, 52 and 66%, respectively, compared with control plots. Phosphogypsum (2.5, 5.0 and 10.0 tons ha−1) decreased emissions of methane 47, 46 and 51%, respectively, over the 84-day study. Nitrous oxide fluxes were low (10–29 g ha−1 day−1) and only detected from control plots on two sampling dates. The assimilation of applied 15N in grain collected from gypsum plots was significantly higher compared with control and phosphogypsum treatments. The measured grain 226Ra activities were low and averaged 0.518 Bq kg−1 for phosphogypsum compared with a control plot activity of 0.222 Bq kg−1.