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Background We report the outcome of autologous stem cell transplant (ASCT) in multiple myeloma (MM) after high dose melphalan with peripheral blood stem cell (PBSC) rescue without cryopreservation in terms of feasibility, safety and 100 day morbidity and mortality. Methods Between Sept 1994 and Feb 2012 a total of 81 patients (56 males, 25 females) were treated with non cryopreserved ASCT, with conditioning regimen of high dose melphalan 140-200 mg/m2 given on day-1. PBSC was collected after G-CSF mobilization with a mean number of leukapheresis of 1.5 (range 1-3) and was stored at 40C for 1-3 days (median = 2) before reinfusion on day 0. The median MNC was 3.0 x 108/kg (range 0.99 – 8.07) and CD34 dose was 2.34 x 106/kg (range 0.18 – 7.67). Results Median age was 50 years (range 22-65). The median time from diagnosis to transplant was 12.1 months (range 4.3 - 99.9). Prior to transplant, 67 patients (83%) had chemosensitive disease (CR, VGPR, PR) and 13(16%) had chemoresistant (stable, refractory or progressive) disease. Forty five (55%) patients had an ECOG PS of 0-1. The median score for hematopoietic cell transplant comorbidity index (HCT-CI) was 0 (range 0-6). The median time to neutrophil engraftment was 10 days (range 8-27) and platelet engraftment was 14 days (range 9-38). Febrile neutropenia occurred in 98.7% patients with a clinically defined focus observed in 14.8%, microbiologically documented infection in 27.1% and fever of unknown origin in 56.7% cases. Antibiotics were used for a median of 10 days (range 5-42). Total toxicity score (sum of toxicity grades for all organs as per Seattle criteria) ranged from 0-13 (median =2) and the median length of hospital stay (LOS) was 18 days (range 12-62). Day 100 mortality was 2.4% (n = 2). Disease status post transplant was CR in 14.8%, VGPR in 60.4% and PR in 11.1% with stable or refractory disease in 8.6%. LOS significantly correlated with age ≥ 50 yrs and HCT-CI of > 0 (p = 0.028 and 0.007 respectively) but not with ECOG PS (p = 0.28). Cumulative toxicity score had no significant correlation with either age, HCT-CI or PS. Conclusion ASCT in MM using non cryopreserved PBSC graft is safe and effective. It may be a prudent alternative with potential for wider applicability. Disclosure All authors have declared no conflicts of interest.

Background The significance of the mutations in FLT3 and c-kit genes in AML has been well established but the role of their expression is not studied together. The aim of this study was to evaluate clinical significance of FLT3 (CD135) and c-kit (CD117) co-expression on myeloblasts in AML. Methods Five ml peripheral blood/bone marrow from consecutive AML patients at diagnosis from April 2008 to May 2010 was evaluated by flow-cytometry. CD135 and CD117 expression was evaluated on dim CD45 positive myeloblasts. Positive expression was considered as >20% surface antigen expression. Results During the study period, there were 115 AML patients with median age 16 years and male:female ratio 2.02:1. M2 was the most common subtype 57% (66/115) followed by M4 14% (16/115). Cytogenetically (n = 85) these patients were classified as good risk in 20 (23%), intermediate risk in 50 (59%) and poor risk in 15 (18%) patients. Flt3 internal tandem duplication was present in 20 (17%) patients. CD135 was positive in 95 (82%) patients; CD117 was positive in 104 (90%) patients; co-expression of CD135 and CD117 was observed in 74 (64%) patients. In those patients who co-expressed CD135 and CD117, the median expression was 34.1% of the gated myeloblasts and patients were classified as high co-expression (>/= 34.1% expression) and low ( Conclusion High co-expression of proliferative markers CD135 and CD117 is an independent prognostic factor for poor outcome in AML. Disclosure All authors have declared no conflicts of interest.