Kinetics of Light-Responsive CNT / PNIPAM Hydrogel Microactuators

Light-responsive microactuators composed of vertically aligned carbon nanotube (CNT) forests mixed with poly(N-isopropylacrylamide) (PNIPAM) hydrogel composites are studied. The benefit of this composite is that CNTs act as a black absorber to efficiently capture radiative heating and trigger PNIPAM contraction. In addition, CNT forests can be patterned accurately using lithography to span structures ranging from a few micrometers to several millimeters in size, and these CNT-PNIPAM composites can achieve response times as fast as 15 ms. The kinetics of these microactuators are investigated through detailed analysis of high-speed videos. These are compared to a theoretical model for the deswelling dynamics, which combines thermal convection and polymer diffusion, and shows that polymer diffusion is the rate-limiting factor in this system. Applications of such CNT/hydrogel actuators as microswimmers are discussed, with light-actuating micro-jellyfish designs exemplified, and >1500 cycles demonstrated.

356 Reducing Long Term Opioid Prescribing Post Thoracic Surgery

Introduction

Patients are routinely started on strong opioid analgesia after surgery with most receiving a prescription for these to continue discharge. We examine the analgesia prescribed in our unit, comparing to ERAS principles from EACTS. We aimed to reduce the total equivalent dose of morphine prescribed on discharge by implementing ERAS principles.

Method

We undertook a retrospective analysis of the analgesia prescribing for patients post open and VATS procedure noting the total dose opioids (using the equivalent dose of morphine). We examined how many patients were still being prescribed opioids analgesia long term, defined as 6 weeks post procedure. We implemented ERAS principles, changing to morphine rather than oxycodone, using short-acting preparations and increasing use of opioid sparing analgesia including NSAIDs.

Results

20% of patients started on strong opioids post procedure were still being prescribed these 6 weeks later. We used ERAS principles to reduce the equivalent dose of morphine dispensed on discharge by a third.

Conclusions

We identified a significant issue with long term opioid prescribing and initiated measures which have resulted in positive change. Our next cycle will measure the outcome of our changes on long-term prescribing implement a multi-disciplinary approach to try reducing the burden of long-term opioid prescribing further.

Natural Carbon By-Products for Transparent Heaters: The Case of Steam-Cracker Tar

Steam-cracker tar (SCT) is a by-product of ethylene production that is in massive quantities globally (>150 × 10⁶ tons per year). With few useful applications, the production of unwanted SCT leads to the need for its costly disposal or burning at the boiler plant. The discovery of new uses for SCT would therefore bring both economic and environmental benefits, although, to date, efforts toward employing SCT in diverse applications have been limited, and progress is further hampered by a lack of understanding of the material itself. Although complex and highly heterogeneous in nature, the molecular composition of SCT has the potential to serve as a diverse and tunable feedstock for wide-ranging applications. Here, a simple solution-processing method for SCT that allows its conductivity and optical properties to be controlled over orders of magnitude is reported. Here, by way of example, the focus is on the production of transparent conductive thin films, which exhibit a wide range of transparencies (23-93%) and sheet resistances (2.5 Ω □^-1 to 1.2 kΩ □^-1 ) that are tuned by a combination of solution concentration and thermal annealing. As transparent Joule heaters, even without optimization, these SCT devices show competitive performance compared to established technologies such as those based on reduced graphene oxide, and surpass the temperature stability limit of other materials. Furthermore, it is demonstrated that laser annealing can be used to process the SCT films and directly pattern transparent heaters on an arbitrary substrate. These results highlight the potential of SCT as a feedstock material for electronic applications and suggest that broader classes of either naturally occurring carbon or produced carbonaceous by-products could prove useful in a range of applications.

The Effect of Materials Architecture in TiO2 /MOF Composites on CO2 Photoreduction and Charge Transfer

CO₂ photoreduction to C₁ /C₁₊ energized molecules is a key reaction of solar fuel technologies. Building heterojunctions can enhance photocatalysts performance, by facilitating charge transfer between two heterojunction phases. The material parameters that control this charge transfer remain unclear. Here, it is hypothesized that governing factors for CO₂ photoreduction in gas phase are: i) a large porosity to accumulate CO₂ molecules close to catalytic sites and ii) a high number of "points of contact" between the heterojunction components to enhance charge transfer. The former requirement can be met by using porous materials; the latter requirement by controlling the morphology of the heterojunction components. Hence, composites of titanium oxide or titanate and metal-organic framework (MOF), a highly porous material, are built. TiO₂ or titanate nanofibers are synthesized and MOF particles are grown on the fibers. All composites produce CO under UV-vis light, using H₂ as reducing agent. They are more active than their component materials, e.g., ≈9 times more active than titanate. The controlled composites morphology is confirmed and transient absorption spectroscopy highlights charge transfer between the composite components. It is demonstrated that electrons transfer from TiO₂ into the MOF, and holes from the MOF into TiO₂ , as the MOF induces band bending in TiO₂ .

Outcomes of adult dual kidney transplants by KDRI in the United States

UNOS guidelines provide inadequate discriminatory criteria for kidneys that should be transplanted as single (SKT) versus dual (DKT). We evaluated the utility of the kidney donor risk index (KDRI) to define kidneys with better outcomes when transplanted as dual. Using SRTR data from 1995 to 2010 of de novo KTX recipients of adult deceased-donor kidneys, we examined outcomes of SKT and DKT stratified by KDRI group ≤1.4 (n = 49 294), 1.41-1.8 (n = 15 674), 1.81-2.2 (n = 6523) and >2.2 (n = 2791). DKT of kidneys with KDRI >2.2 was associated with significantly better overall graft survival [adjusted hazard ratio (aHR) 0.83, 95% confidence interval (CI) 0.72-0.96] compared to single kidneys with KDRI >2.2. DKT was associated with significantly decreased odds of delayed graft function (top 2 KDRI categories) and significantly decreased odds of 1-year serum creatinine level >2 mg/dL (top 3 KDRI categories). Among SKT and DKT from KDRI >2.2 there were 16.1 and 13.9 graft losses per 100 patient follow-up years, respectively. KDRI >2.2 is a useful discriminatory cut-off for the determination of graft survival benefit with the use of DKT; however, the benefit of increased graft years was less than half of single kidneys from donors in the same KDRI range.

Abstract LB-308: Combination of CTx-0294945 a highly selective inhibitor of focal adhesion kinase with bevacizumab in pre-clinical models of breast cancer

Background: Focal adhesion kinase (FAK) is a non-receptor tyrosine kinase that provides a critical hub for signalling from at least four different classes of cellular sensing mechanisms including growth factor receptors, GPCRs, integrins and mechanical stress forces. By temporal and spatial integration of signals from these sources, FAK plays a central role in cell migration, invasion and proliferation; processes vital for tumorigenesis. The significance of FAK to the function of signal transduction pathways provides a strong rationale for the combination of FAK inhibitors with other targeted agents to achieve improved efficacy against a range of cancers. Others have demonstrated the importance of FAK in angiogenesis and therefore combining a FAKi with anti-VEGF agents is attractive as it employs two complementary mechanisms of suppressing the formation of tumor vasculature. Here we present results from the co-administration of CTx-0294945, a highly selective FAKi, and bevacizumab (bev) in an orthotopic model of human breast cancer. Methods and Results: CTx-0294945 is an orally bioavailable small molecule ATP competitive inhibitor of focal adhesion kinase (FAK KD=0.21 nM). It exhibits high selectivity against a diverse panel of 125 kinases including the closely related Pyk2. CTx-0294945 inhibits autophosphorylation of 397Y-FAK in MDA-MB-231 cells with an IC50 = 7 nM and exhibits low general cellular toxicity (IC50 = 2.7 µM, MDA-MB-231 cells). CTx-0294945 is suitable for oral administration (%F=58 and t1/2=5.1 h at 20 mg/Kg in rat) and does not inhibit (IC50 >20 µM) any of the cytochrome p450 isoforms tested to date. To assess the co-administration of CTx-0294945 with bev, mice were injected orthotopically with MDA-MB-231 cells (106). After 14 days, when tumors were palpable, mice were randomized into 4 groups and dosing commenced. The groups were treated with CTx-0294945 (80 mg/kg QD, PO), bev (12.5 mg/Kg IP, x2/week), CTx-0294945 (80 mg/Kg QD, PO) and bev (12.5 mg/Kg IP, x2/week) or vehicle. Tumor growth was monitored and on day 28 animals in the vehicle and CTx-0294945 arms were culled when the size of the tumors reached ethical end point (1000 mm3). Tumor growth in the bev only and the CTx-0294945 + bev arms was significantly inhibited (75% and 88% TGI respectively). At this time the treatment regimes for both cohorts were stopped and tumor growth allowed to progress. After an additional 14 days the experiment was terminated when the bev treatment group reached ethical end point; however the average size of the tumors in the CTx-0294945 + bev cohort was still was only 562 mm3. Conclusions: Our data suggest the potential utility of combining a selective FAK inhibitor with bevacizumab to prevent tumour progression and enhance the durability of response.

Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr LB-308. doi:1538-7445.AM2012-LB-308

AN OUTBREAK OF PSITTACOSIS IN PIGEONS, INVOLVING THE PRODUCTION OF INCLUSION BODIES, AND TRANSFER OF THE DISEASE TO MAN

An epizootic disease in pigeons associated with atypical pneumonia in two persons handling the birds has been studied. Most of the observations made during the work were consistent with the idea that we were dealing with an infection caused by a member of the psittacosis-lymphogranuloma venereum group of viruses. The outbreak was peculiar, however, in that tissues of the diseased pigeons contained many intranuclear inclusions and that the viruses isolated from these birds produced both intranuclear inclusions and elementary bodies in the cytoplasm of cells of chorio-allantoic membranes of the developing egg. Whether the pigeons were simultaneously infected with two viruses or whether the virus of pigeon psittacosis can produce intranuclear inclusions under certain conditions remains to be determined.

Mobilization of haemopoietic stem cells by cyclophosphamide into the peripheral blood of patients with haematological malignancies

Thirty one peripheral blood stem cell mobilizations using cyclophosphamide, followed by leucapheresis, were performed in 25 patients with a variety of haematological malignancies. Cyclophosphamide at doses ranging from 0.25 g/M2/day x 4 days to 4 g/M2 on one day were given. Total doses of cyclophosphamide less than 4 g/M2 failed to induce a significant mobilization of stem cells into the peripheral blood. This compares to cyclophosphamide doses of 4 g/M2 given over one or two days where 70%-75% of patients yielded adequate stem cells for transplantation (greater than 20 x 10(4) CFU-GM/kg). Both the presence of tumour cells in the bone marrow and previous chemotherapy within 12 months of cyclophosphamide infusion significantly diminished the patients stem cell mobilizations. The rate of recovery of the patient's leucocyte count following cyclophosphamide was highly correlated to the peak level of PB CFU-GM and is a good indicator of the total stem cell yield. Fever in 50% of patients during the period of cytopaenia was the only complication seen in our patients and thus high dose cyclophosphamide is a suitable and safe agent for mobilizing haemopoietic stem cells.

Nectar-secreting floral stomata in Maxillaria anceps Ames & C. Schweinf. (Orchidaceae)

BACKGROUND AND AIMS

Although it was generally assumed that Maxillaria spp. do not produce nectar, in recent years, nectar has been reported for a number of these orchids. Nevertheless, our current understanding of nectary structure and nectar secretion in Maxillaria is based solely on M. coccinea (Jacq.) L.O. Williams ex Hodge, which, since it shows many features characteristic of ornithophilous flowers, is atypical of this largely entomophilous genus. The aim of the present paper is to describe, for the first time, nectar secretion in a presumed entomophilous species of Maxillaria.

METHODS

The structure of the nectary of M. anceps Ames & C. Schweinf., nectar composition and the process of nectar secretion were investigated using light microscopy, scanning electron microscopy, transmission electron microscopy, histochemistry, refractometry and high performance liquid chromatography.

KEY RESULTS AND CONCLUSIONS

Nectar appears as droplets that are exuded by modified stomata borne upon the labellar callus and collects upon the labellum and at the base of the column-foot. Although such stomata are known to occur in a number of angiosperm families, this is the first time for them to be observed in orchids. The callus consists largely of parenchyma with raphides and is supplied by eight to ten collateral bundles. This tissue, together with the single-layered epidermis, seemingly contains terpenoids. During the bud stage, the callus cells contain an organelle complement consistent with secretory cells whereas by day 4 of anthesis, much of the cell is occupied by a vacuole. The nectar is sucrose-dominant but also contains low concentrations of glucose, fructose, free amino acids and possibly terpenoids. The high sugar concentration (approx. 66 %) is consistent with melittophily and may indicate that, like the majority of Maxillaria spp., M. anceps is visited by stingless bees (Meliponini).

Comparative account of nectary structure in Hexisea imbricata (Lindl.) Rchb.f. (Orchidaceae)

BACKGROUND AND AIMS

Despite the number of orchid species that are thought to be pollinated by hummingbirds, our knowledge of the nectaries of these orchids is based solely on a single species, Maxillaria coccinea (Jacq.) L.O. Williams ex Hodge. Nevertheless, it is predicted that such nectaries are likely to be very diverse and the purpose of this paper is to compare the nectary and the process of nectar secretion in Hexisea imbricata (Lindl.) Rchb.f. with that of Maxillaria coccinea so as to begin to characterize the nectaries of presumed ornithophilous Neotropical orchids.

METHODS

Light microscopy, transmission electronmicroscopy and histochemistry were used to examine the histology and chemical composition of nectary tissue and the process of nectar secretion in H. imbricata.

KEY RESULTS AND CONCLUSIONS

The nectary of H. imbricata has a vascular supply, is bound by a single-layered epidermis with few stomata and comprises two or three layers of subepidermal secretory cells beneath which lie several layers of palisade-like parenchymatous cells, some of which contain raphides or mucilage. The secretory cells are collenchymatous and their walls have numerous pits with associated plasmodesmata. They contain the full complement of organelles characteristic of secretory cells as well as intravacuolar protein bodies but some of the secretory epidermal cells, following secretion, collapse and their anticlinal walls seem to fold. Nectar secretion is thought to be granulocrine and, following starch depletion, lipid droplets collect within the plastids. The nectar accumulates beneath the cuticle which subsequently forms swellings. Finally, nectar collects in the saccate nectary spur formed by the fusion of the margins of the labellum and the base of the column-foot. Thus, although the nectary of H. imbricata and M. coccinea have many features in common, they nevertheless display a number of important differences.

Nectary structure and nectar secretion in Maxillaria coccinea (Jacq.) L.O. Williams ex Hodge (Orchidaceae)

BACKGROUND AND AIMS

It had previously been assumed that Maxillaria spp. produce no nectar. However, nectar has recently been observed in Maxillaria coccinea (Jacq.) L.O. Williams ex Hodge amongst other species. Furthermore, it is speculated that M. coccinea may be pollinated by hummingbirds. The aim of this paper is to investigate these claims further.

METHODS

Light microscopy, histochemistry, scanning and transmission electron microscopy.

KEY RESULTS

This is the first detailed account of nectar secretion in Maxillaria Ruiz & Pav. A 'faucet and sink' arrangement occurs in M. coccinea. Here, the nectary is represented by a small protuberance upon the ventral surface of the column and nectar collects in a semi-saccate reservoir formed by the fusion of the labellum and the base of the column-foot. The nectary comprises a single-layered epidermis and three or four layers of small subepidermal cells. Beneath these occur several layers of larger parenchyma cells. Epidermal cells lack ectodesmata and have a thin, permeable, reticulate cuticle with associated swellings that coincide with the middle lamella between adjoining epidermal cells. Nectar is thought to pass both along the apoplast and symplast and eventually through the stretched and distended cuticle. The secretory cells are collenchymatous, nucleated and have numerous pits with plasmodesmata, mitochondria, rough ER and plastids with many plastoglobuli but few lamellae. Subsecretory cells have fewer plastids than secretory cells. Nectary cells also contain large intravacuolar protein bodies. The floral morphology of M. coccinea is considered in relation to ornithophily and its nectary compared with a similar protuberance found in the entomophilous species M. parviflora (Poepp. & Endl.) Garay.

CONCLUSIONS

Flowers of M. coccinea produce copious amounts of nectar and, despite the absence of field data, their morphology and the exact configuration of their parts argue strongly in favour of ornithophily.

Uterine evacuation with misoprostol during radiotherapy for cervical cancer in pregnancy

Radiotherapy as definitive treatment for invasive cervical cancer during pregnancy causes spontaneous abortion in most cases. Surgical evacuation of the uterus is indicated when abortion does not occur, exposing patients to additional morbidity. Two Latin American women, diagnosed with FIGO stage IB2 cervical cancer at approximately 15 weeks gestation, underwent radiotherapy with radiosensitizing chemotherapy. After intrauterine fetal demise was detected, both women underwent induction with misoprostol. Results included one complete abortion and one incomplete abortion without complications or delays in treatment. These cases demonstrate that induction with misoprostol appears to be a safe and effective alternative to surgical evacuation of the uterus when spontaneous abortion fails to occur during radiotherapy for locally advanced cervical cancer.

Lipoidal labellar secretions in Maxillaria ruiz & pav. (Orchidaceae)

The labella of Maxillaria acuminata Lindl., M. cerifera Barb. Rodr. and M. notylioglossa Rchb.f., all members of the M. acuminata alliance, produce a viscid wax-like secretion. Histochemical analysis revealed that the chemical composition of the secretion is similar in all three species, consisting largely of lipid and protein. Light microscopy and low-vacuum scanning electron microscopy were used to investigate the secretory process. In a fourth taxon, M. cf. notylioglossa, transmission electron microscopy showed that lipid bodies are associated with smooth endoplasmic reticulum or occur as plastoglobuli within plastids. Lipid bodies vary in appearance and this may reflect differences in chemical composition. They become associated with the plasmalemma and eventually accumulate between the latter and the cell wall. The wall contains no pits or ectodesmata, and it is speculated that lipid passes through the wall as small lipid moieties before eventually reassembling to form lipid globules on the external surface of the cuticle. These globules are able to coalesce forming extensive viscid areas on the labellum. The possible significance of this process to pollination is discussed.

Identification of Y chromatin directly in gonadal tissue by fluorescence in situ hybridization (FISH): significance for Ullrich-Turner syndrome screening in the cytogenetics laboratory

The presence of Y chromatin in individuals with Ullrich-Turner syndrome (UTS) confers a risk for gonadoblastoma. In mosaic cases, little is known about Y chromatin distribution in gonads. Fluorescence in situ hybridization (FISH) is a direct approach to assess the extent of Y chromatin mosaicism in gonads. Gonadal tissue from four patients with mosaic karyotypes were analyzed by routine cytogenetics and FISH with X and Y centromere probes. Y chromatin was present in gonads in varying percentages in these patients. The distribution of Y chromatin in gonads of UTS individuals did not completely correlate with that found in blood lymphocytes. The finding of Y chromatin in the blood samples from these patients prompted the development of a screening strategy in our cytogenetics laboratory to detect low-level Y chromatin mosaicism in patients with UTS.

A system for investigating oesophageal photoplethysmographic signals in anaesthetised patients

The monitoring of arterial blood oxygen saturation in patients with compromised peripheral perfusion is often difficult, because conventional non-invasive techniques such as pulse oximetry (SpO2) can fail. Poor peripheral circulation commonly occurs after major surgery including cardiopulmonary bypass. The difficulties in these clinical situations might be overcome if the sensor were to monitor a better perfused central part of the body such as the oesophagus. A new oesophageal photoplethysmographic (PPG) probe and an isolated processing system have been developed to investigate the pulsatile signals of anaesthetised adult patients undergoing routine surgery. Measurements were made in the middle third of the oesophagus, 25 cm to 30 cm from the upper incisors. The AC PPG signals are sampled by a data acquisition system connected to a laptop computer. The signals recorded correspond to infrared and red AC PPGs from the middle third oesophagus and the finger. Preliminary results from 20 patients show that good quality AC PPG signals can be measured in the human oesophagus. The ratio of the oesophageal to finger AC PPG amplitudes was calculated for the infrared and red wavelengths for each patient. The mean (+/- standard deviation) of this ratio was 2.9 +/- 2.1 (n = 19) for the infrared wavelength and 3.1 +/- 2.4 (n = 16) for the red wavelength. The red and infrared wavelengths used are appropriate for pulse oximetry and this investigation indicates that the mid-oesophagus may be a suitable site for the reliable monitoring of SpO2 in patients with poor peripheral perfusion.

Epidemiology of congenital cytomegalovirus infection: maternal risk factors and molecular analysis of cytomegalovirus strains

To determine factors that influence the occurrence of congenital cytomegalovirus (CMV) infection, the authors surveyed prospectively 8,254 infants born in eastern Iowa between October 1989 and June 1994. The authors conducted a case-control study to identify maternal risk factors, matching each CMV-infected infant with three uninfected infants according to hospital and date of birth. CMV strains were compared by using the polymerase chain reaction (PCR) to identify common sources of infection. Of the 7,229 infants cultured successfully for CMV, 35 (0.48%) were congenitally infected. Mothers of CMV-infected infants were more likely to be single (odds ratio (OR) = 3.05, p = 0.016), to work in sales (OR = 4.93, p = 0.008), or to be students (OR = 5.01, p = 0.017). Conversely, women who worked in health-care professions were less likely to have a congenitally infected infant (OR = 0.14, p = 0.049). PCR analysis indicated 27 distinct strains of CMV, but two groups of infants (two infants per group) excreted strains with indistinguishable molecular patterns. One of these pairs of infants had older siblings who attended the same child-care center during their mothers' pregnancies. The authors concluded that demographic and occupational factors influenced the risk of giving birth to an infant with congenital CMV infection. Many distinct CMV strains were identified, suggesting that major point source outbreaks had not occurred. Nonetheless, point source acquisition of CMV from child-care environments did account for some cases of congenital CMV infection in eastern Iowa.

Cytomegalovirus infection in newborns and their family members: polymerase chain reaction analysis of isolates

Polymerase chain reaction (PCR) analysis with primers for the pp65, a-sequence, glycoprotein B, and major immediate early genes of human cytomegalovirus (CMV) was used to study five congenitally-infected infants and their CMV-infected family members. Family members excreting CMV included three mothers and two siblings. The PCR results indicated that the CMV strain excreted by each infant was indistinguishable from that excreted by the corresponding family member. By contrast, the molecular profiles of the CMV strains were distinct between families, indicating that the PCR algorithm described in this study is a useful method for analyzing CMV strains.

Growth deficient fetuses with absent or reversed umbilical artery end-diastolic flow are metabolically compromised

Controversy continues regarding the clinical relevance of absent or reversed umbilical artery blood flow during diastole. The purpose of this study was to characterize the blood gas and lactate measurements of growth deficient fetuses with absent (ADF) or reversed (RDF) umbilical artery (UA) diastolic flow. In a descriptive study from February 1988 through October 1991, 42 consecutive structurally and karyotypically normal growth deficient fetuses identified to have either ADF or RDF diastolic flow in the UA were studied. Heparinized blood specimens were obtained from them and the pH, PCO2, PO2 and lactate measured. Fourteen of these specimens were obtained from the umbilical vein by cordocentesis and 28 at the caesarean delivery of non-labouring patients. Statistical analyses were performed using Fisher's exact test, Student t-test and linear correlation. All measured parameters in fetuses with ADF or RDF undergoing cordocentesis were significantly abnormal compared to gestational age corrected norms. Both the mean venous and arterial pH of fetuses with RDF were significantly lower than that of fetuses with ADF. With few exceptions, preoperative maternal oxygenation failed to correct the fetal hypoxaemia associated with either ADF or RDF. In the setting of severe fetal growth deficiency secondary to uteroplacental dysfunction, ADF and RDF are clinically reliable indicators of fetal compromise as determined by the umbilical blood gases. RDF is associated with a greater impairment of placental gas exchange than ADF.

Factors affecting blood stem cell collections following high-dose cyclophosphamide mobilization in lymphoma, myeloma and solid tumors

Sixty patients with malignancy were enrolled in a study of high-dose chemotherapy and peripheral blood stem cell transplantation (PBSCT). Stem cells were harvested prior to PBSCT using high-dose cyclophosphamide (CY) mobilization (4 or 7 g/m2) with collection of a median of 4.6 x 10(8)/kg mononuclear cells (range 0.2-9.5) and 21.6 x 10(4)/kg colony forming unit-granulocyte/macrophage (CFU-GM) (range 0.1-220). Forty-seven patients were mobilized once, 11 required two cycles and two required three cycles. Eight patients (13%) failed to reach the optimum CFU-GM target (greater than 15 x 10(4)/kg) following CY mobilization. A number of factors identified those patients who were likely to achieve optimum CFU-GM collections with CY mobilization. These included the use of the higher CY mobilization dose, a longer interval from last chemotherapy cycle to mobilization, and a higher premobilization bone marrow CFU-GM level. Patient's age, the degree of bone marrow infiltration, the nature of disease or the number of pre-mobilization chemotherapeutic cycles did not affect the ability to collect optimum CFU-GM numbers. Whilst the mobilization procedure was associated with moderate non-hematologic toxicity, significant hematological morbidity was observed primarily in patients mobilized using the 7 g/m2 dose. Refinements to the protocol, in particular the use of hematopoietic growth factors, are currently under investigation.