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All commercially available cochlear implant (CI) systems use an external microphone and sound processor; however, external equipment carries lifestyle limitations. Although totally implantable devices using subcutaneous microphones have been developed, these are compromised by problems with soft tissue sound attenuation, feedback, and intrusive body noise. This in vivo pilot study evaluates a middle ear microphone (MEM) that aims to overcome these issues and compares hearing performance with that of an external CI microphone.Six adult participants with an existing CI were implanted with a temporary MEM in the contralateral ear. Signals from the MEM were routed via a percutaneous plug and cable to the CI sound processor. Testing was performed in the CI microphone and MEM conditions using a range of audiometric assessments, which were repeated across four visits.Performance of the MEM did not differ significantly from that of the CI on the assessments of Auditory Speech Sounds Evaluation loudness scaling at either 250 or 1000 Hz, or in the accuracy of repeating keywords presented at 70 dB. However, the MEM had significantly poorer aided sound-field thresholds, particularly at higher frequencies (≥4000 Hz), and significantly poorer performance on Arthur Boothroyd words presented at 55 dB, compared with the CI.In this pilot study, the MEM showed comparable performance to that of an external CI microphone across some audiometric assessments. However, performance with the MEM was poorer than the CI in soft-level speech (55 dB) and at higher frequencies. As such, the benefits of MEM need to be considered against the compromises in hearing performance. However, with future development, MEM is a potentially promising technology.

The adoption of vegetarian-based dietary patterns among athletes has been gaining popularity. However, limited research examines the dietary behaviours within this group. Therefore, the aim of this study was to examine self-reported dietary behaviours in a cohort of physically active individuals following vegetarian-based dietary patterns, recruited via social media. A 52-item online survey was created with questions related to demographics, physical activity, eating patterns and supplementation use. An external link to the Australian Automated Self-Administered 24-h (ASA24-AU) recall was included to examine nutrient intakes. Dietary quality was assessed using the Alternate Healthy Eating Index-2010 (AHEI-2010) and the Dietary Phytochemical Index (DPI) tools. A total of 781 (84.8%) respondents completed the survey in 2018. Principal motives for adhering to a vegetarian-based dietary pattern included animal rights (86.5%), environmental concerns (75.4%), health reasons (69.6%) and improving physical performance (24.1%). Vitamin B12 was the most commonly reported supplement (58.1%) followed by protein powder (36.3%) and vitamin D (35.9%). A total of 133 respondents completed the ASA24-AU dietary recall with generally adequate nutrient intakes and a high-quality diet as assessed by the AHEI-2010 and DPI. A significant minority of physically active individuals following vegetarian-based diets do so with the aspiration of improving their exercise performance. Dietary quality was considered high in this group for recreational physical activity, although intakes of vitamin B12 and LC n-3 PUFA were low.

Plant‐based dietary patterns are associated with reduced risk of many chronic diseases. Athletes have increasingly been adopting plant‐based diets not only for the related health benefits but for perceived improvements in endurance performance. Several theoretical mechanistic underpinnings have been described as to why a plant‐based dietary pattern may improve endurance performance. This review focuses on plant‐based dietary patterns and their hypothesised ability to modulate endurance performance specifically from an antioxidant, inflammatory and immunological perspective. Studies quantifying the function of plant‐based dietary patterns on endurance performance are scarce; however, research exploring physiological changes in immune, oxidative and inflammatory systems with the adoption of a plant‐based dietary pattern appears to be favourable. Overall, research suggests that the consumption of a plant‐based diet may result in improvements in C‐reactive protein, interleukin‐6, fibrinogen and leukocyte concentrations, while some studies report improved lymphocyte responsiveness and improved natural killer cell functionality. These changes may be the result of an optimised intake of phytochemicals (particularly polyphenols), unrefined carbohydrates and saturated fat which could theoretically translate into small improvements to endurance performance. It is important to note that any improvement to endurance performance via these systems would likely be minor and difficult to quantify; nevertheless, the findings of the current body of evidence highlight the need for further research in this area.

Eating a high-quality diet and engaging in regular physical activity are fundamental components of lifestyle medicine that can reduce the risk of morbidity and mortality. Increased interest in plant-based eating may lead to questions about whether meat-free diets lack certain nutrients, such as creatine, which support vigorous exercise. Creatine supplementation has been consistently shown to improve exercise performance, especially during high-intensity efforts, in individuals following omnivorous and meat-free (vegetarian and vegan) eating patterns. Only foods of animal origin contain dietary creatine, however, leading some to speculate that people eating omnivorous diets may gain a performance advantage relative to their meat-free counterparts. Research revealing dis-crepancies in creatine storage between those eating omnivorous and meat-free diets has not found lower lean body mass, type I or II muscle fiber area, 1-repetition maximum, power output, VO2max, or time to exhaustion. Creatine supplementation augments exercise performance for individuals of all dietary patterns studied but improvements resulting from supplementation have not been consistently greater in subjects who follow meat-free versus omnivorous diets, indicating that their lower baseline creatine stores are unlikely ergolytic. Additional research finds no performance disadvantage for individuals who follow unsupplemented meat-free diets compared to those following unsupplemented omnivorous diets despite their differing creatine stores. These findingsindicate that the discrepant creatine contents of omnivorous and meat-free diets are not associated with differences in lean body mass and exercise performance.

Connectomics—the study of brain networks—provides a unique and valuable opportunity to study the brain. However, research in human connectomics, accomplished via Magnetic Resonance Imaging (MRI), is a resource-intensive practice: typical analysis routines require impactful decision making and significant computational capabilities. Mitigating these issues requires the development of low-resource, easy to use, and flexible pipelines which can be applied across data with variable collection parameters. In response to these challenges, we have developed the MRI to Graphs (m2g) pipeline. m2g leverages functional and diffusion datasets to estimate connectomes reliably. To illustrate, m2g was used to process MRI data from 35 different studies (≈6,000 scans) from 15 sites without any manual intervention or parameter tuning. Every single scan yielded an estimated connectome that followed established properties, such as stronger ipsilateral than contralateral connections in structural connectomes, and stronger homotopic than heterotopic correlations in functional connectomes. Moreover, the connectomes generated by m2g are more similar within individuals than between them, suggesting that m2g preserves biological variability. m2g is portable, and can run on a single CPU with 16 GB of RAM in less than a couple hours, or be deployed on the cloud using its docker container. All code is available on https://neurodata.io/mri/.

Background: Evaluation of the dietary fat consumption in athletes following vegan diets is scarce. The aim of this study was to explore the intakes, availability, and uptake of physiologically rele...

This review describes several limitations of the Digestible Indispensable Amino Acid Score (DIAAS) with a focus on its application to plant-based dietary patterns. Evaluating protein quality in terms of digestibility is paramount to support and optimize the health and well-being of human populations in situations where food insecurity and protein energy malnutrition are widespread. The Food and Agriculture Organization (FAO) of the United Nations has endorsed the DIAAS to replace the previously recommended Protein Digestibility Corrected Amino Acid Score (PDCAAS) for protein quality assessment. While multiple strengths characterize the DIAAS, substantial limitations remain, many of which are accentuated in the context of a plant-based dietary pattern. Some of these limitations include a failure to translate differences in nitrogen-to-protein conversion factors between plant- and animal-based foods, limited representation of commonly consumed plant-based foods within the scoring framework, inadequate recognition of the increased digestibility of commonly consumed heat-treated and processed plant-based foods, its formulation centered on fast-growing animal models rather than humans, and a focus on individual isolated foods vs the food matrix. The DIAAS is also increasingly being used out of context where its application could produce erroneous results such as exercise settings. When investigating protein quality, particularly in a plant-based dietary context, the DIAAS should ideally be avoided.

Cognitive decline occurs in healthy and pathological aging, and both may be preceded by subtle changes in the brain — offering a basis for cognitive predictions. Previous work has largely focused on predicting a diagnostic label from structural brain imaging. Our study broadens the scope of applications to cognitive decline in healthy aging by predicting future decline as a continuous trajectory, rather than a diagnostic label. Furthermore, since brain structure as well as function changes in aging, it is reasonable to expect predictive gains when using multiple brain imaging modalities. Here, we tested whether baseline multimodal neuroimaging data improve the prediction of future cognitive decline in healthy and pathological aging. Non-brain data (including demographics and clinical and neuropsychological scores) were combined with structural and functional connectivity MRI data from the OASIS-3 project (N = 662; age = 46 – 96y). The combined input data was entered into cross-validated multi-target random forest models to predict future cognitive decline (measured by the Clinical Dementia Rating and the Mini-Mental State Examination), on average 5.8y into the future. The analysis was preregistered and all analysis code is publicly available. We found that combining non-brain with structural data improved the continuous prediction of future cognitive decline (best test-set performance: R2= 0.42) and that cognitive performance, daily functioning, and subcortical volume drove the performance of our model. In contrast, including functional connectivity did not improve predictive accuracy. In the future, the prognosis of age-related cognitive decline may enable earlier and more effective cognitive, pharmacological, and behavioral interventions to be tailored to the individual.

Objective:To identify the key features of a nutrition resource that are important to adolescents of a low socioeconomic status (SES).Design:Structured interviews were conducted to explore participants’ preferences relating to the features of a nutrition resource. Thematic framework analysis was used to determine key themes, subthemes and concepts from the data.Setting:Streetsport activity sessions, north-east of Scotland.Participants:Eighteen adolescents aged 12–17 years from a low socioeconomic background.Results:The overarching themes identified were barriers and facilitators to engagement with a nutrition resource. Adolescents expressed a preference for an app, and this was mainly attributed to convenience and low cost. There was also an emphasis on the integral role social media has in their lives. Aesthetics was a facilitator for both male and female participants, with a particular focus on weight loss. Behaviour change support, including reminders, access to simple recipes and adopting a ‘small change approach’, were identified as possible facilitators, whereas cost, environmental influences, and existing eating habits were identified as possible barriers to engaging with a nutrition resource.Conclusions:A number of subthemes, including aesthetics, cost and convenience, which have previously been reported in adolescents with a higher SES, were prominent in our research. The present study contributes to insights relating to behaviour change tools that should be considered when developing a nutrition resource targeting disadvantaged adolescents. Further research focusing on how mobile phone technology and social media can be utilised to support dietary behaviour change in low SES adolescents is recommended.

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In this paper, we propose a procedure to find differential edges between two graphs from high-dimensional data. We estimate two matrices of partial correlations and their differences by solving a penalized regression problem. We assume sparsity only on differences between two graphs, not graphs themselves. Thus, we impose an ℓ(2) penalty on partial correlations and an ℓ(1) penalty on their differences in the penalized regression problem. We apply the proposed procedure to finding differential functional connectivity between healthy individuals and Alzheimer’s disease patients.

Magnetic resonance imaging (MRI) has detected changes in pancreas volume and other characteristics in type 1 and type 2 diabetes. However, differences in MRI technology and approaches across locations currently limit the incorporation of pancreas imaging into multisite trials. The purpose of this study was to develop a standardized MRI protocol for pancreas imaging and to define the reproducibility of these measurements. Calibrated phantoms with known MRI properties were imaged at five sites with differing MRI hardware and software to develop a harmonized MRI imaging protocol. Subsequently, five healthy volunteers underwent MRI at four sites using the harmonized protocol to assess pancreas size, shape, apparent diffusion coefficient (ADC), longitudinal relaxation time (T1), magnetization transfer ratio (MTR), and pancreas and hepatic fat fraction. Following harmonization, pancreas size, surface area to volume ratio, diffusion, and longitudinal relaxation time were reproducible, with coefficients of variation less than 10%. In contrast, non-standardized image processing led to greater variation in MRI measurements. By using a standardized MRI image acquisition and processing protocol, quantitative MRI of the pancreas performed at multiple locations can be incorporated into clinical trials comparing pancreas imaging measures and metabolic state in individuals with type 1 or type 2 diabetes.

Dietary patterns with substantial proportions of energy from plant sources have been associated with favorable biomarkers of low-grade inflammation. Less is known of the relation between vegetarian-based dietary patterns and markers of inflammation and immune status. This systematic review and meta-analysis aimed to determine the relation between vegetarian-based dietary patterns and inflammatory and immune markers (C-reactive protein, tumour necrosis factor α, fibrinogen, natural killer cells, leukocytes, lymphocytes, thrombocytes, interleukins, and immunoglobulins). PubMed, Medline, and Cochrane scientific databases were searched to identify relevant studies. Random effects meta-analyses were conducted to assess the weighted mean differences (WMDs) for each outcome variable between vegetarian and non-vegetarian groups. Thirty observational and 10 intervention studies were included in the review. Pooled effects of vegetarian-based dietary patterns were associated with significantly lower concentrations of CRP (WMD: -0.61 mg/L; 95% CI: -0.91, -0.32 mg/L; P = 0.0001), fibrinogen (WMD: -0.22 g/L; 95% CI: -0.41, -0.04 mg/L; P = 0.02), and total leukocyte (WMD: -0.62 × 10(3)/μL; 95% CI -1.13 × 10(3), -0.10 × 10(3)/μL; P = 0.02) compared with those following non-vegetarian dietary patterns in observational studies. Insufficient data were identified for a meta-analysis of intervention studies. This study provides evidence that vegetarian-based dietary patterns are associated with lowered serum C-reactive protein, fibrinogen, and total leukocyte concentrations. Future research should focus on large-scale intervention trials, contrasting differences in inflammation and immune status and function between vegetarian and non-vegetarian-based populations.

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Introduction Acute myeloid leukaemia (AML) is an aggressive haematological malignancy which is more common in the elderly and has a poor 5-year survival. There are no established beneficial interventions to treat AML in elderly patients. It is unclear whether outpatient delivery of palliative chemotherapies could reduce the burden of disease and hospitalisation for this group. Aims To compare overall survival, response to treatment and supportive care needs between inpatient and outpatient-based treatments for AML in elderly patients. Materials & Methods We undertook a retrospective cohort study in the Haematology Department at Belfast City Hospital comparing overall survival (OS), treatment responses and supportive care needs between inpatient and outpatient treatments for AML in elderly patients. Consecutive entrants to outpatient and inpatient based clinical trials between February 2013 and January 2017 were included. Case notes, chemotherapy charts, clinic letters, blood bank and electronic care records were analysed. Results OS and rates of CR (complete remission), CRi (CR with incomplete count recovery) and PR (partial response) was not significantly different between inpatient and outpatient regimens with a median OS of 201 vs. 124 days, respectively. No response was observed in 35% of patients in the inpatient group compared with 65% of the outpatient group, however this did not reach significance. Of patients who achieved CR/CRi in the outpatient group, 75% relapsed at a median of 271 days, compared with 60% of the inpatient group at a median of 209 days. At least one grade 3-4 toxicity was experienced by 90% and 83.3% of inpatient and outpatient groups, respectively. There was no difference in six common grade 3-4 toxicities. Patients on the outpatient regimen spent fewer days in hospital but had a median packed red cell use of more than twice that of the inpatient group. No difference was noted in infections, days on antibiotics or platelet use. Discussion Our data suggests that outpatient chemotherapy is safe and can reduce hospitalisation for elderly patients with AML, without a decline in OS or response rates. These results provide an important rationale to test the comparative efficacy of outpatient chemotherapy. Chemotherapy related toxicities remain a significant source of morbidity in this population and highlight the need to develop novel, targeted therapies for this age group.

Adults with psychotic disorders have dysconnectivity in critical brain networks, including the default mode (DM) and the cingulo-opercular (CO) networks. However, it is unknown whether such deficits are present in youth with less severe symptoms. We conducted a multivariate connectome-wide association study examining dysconnectivity with resting state functional magnetic resonance imaging in a population-based cohort of 188 youths aged 8-22 years with psychosis-spectrum (PS) symptoms and 204 typically developing (TD) comparators. We found evidence for multi-focal dysconnectivity in PS youths, implicating the bilateral anterior cingulate, frontal pole, medial temporal lobe, opercular cortex and right orbitofrontal cortex. Follow-up seed-based and network-level analyses demonstrated that these results were driven by hyper-connectivity among DM regions and diminished connectivity among CO regions, as well as diminished coupling between frontal and DM regions. Collectively, these results provide novel evidence for functional dysconnectivity in PS youths, which show marked correspondence to abnormalities reported in adults with established psychotic disorders.

Background Vegetarians are likely to have lower intakes of preformed docosahexaenoic acid (DHA) than omnivorous populations who consume fish and animal products. As such, vegetarian populations have omega-3 indices up to 60% lower than those who consume marine products. Algae, the primary producer of DHA in the marine food chain, offer an alternative source of DHA for those who do not consume marine or animal products. This systematic review aims to examine the evidence for the relationship between supplementation with algal forms of DHA and increased DHA concentrations in vegetarian populations. Methods The SCOPUS, Science Direct and Web of Science scientific databases were searched to identify relevant studies assessing the effect of algal DHA consumption by vegetarian (including vegan) populations. Results Four randomised controlled trials and two prospective cohort studies met the inclusion criteria. All included studies reported algal sources of DHA significantly improve DHA concentrations (including plasma, serum, platelet and red blood cell fractions), as well as omega-3 indices, in vegetarian populations. An evident time or dose response was not apparent given the small number of studies to date. Conclusions Future studies should address long chain n-3 polyunsaturated fatty acid deficiencies in vegetarian populations using algal DHA and explore the potential physiological and health improvements in these individuals.

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of a conference presentation. Publication Details Craddock, J. C., Probst, Y. & Peoples, G. (2016). Vegetarian nutrition Comparing physical performance of omnivorous and vegetarian athletes. In The Nutrition Society of Australia and New Zealand 2015 Annual Scientific Meeting, 1-4 Dec 2015, Wellington, New Zealand. Journal of Nutrition & Intermediary Metabolism, 4 19-19. This conference paper is available at Research Online: http://ro.uow.edu.au/smhpapers/4020 VEGETARIAN NUTRITION e COMPARING PHYSICAL PERFORMANCE OF OMNIVOROUS AND VEGETARIAN ATHLETES J.C. Craddock , Y. Probst , G. Peoples . 1 School of Medicine, University of Wollongong, NSW, Australia; 2 Smart Foods Centre, University of Wollongong, NSW, Australia E-mail address: jcc256@uowmail.edu.au (J.C. Craddock) Background/Aims: Humans consuming a vegetarian diet have a reduced relative risk in coronary heart disease, hypertension, diabetes mellitus, obesity and some cancers. Regular physical activity also assists in preventing, and reducing the severity of these conditions. An association between these two factors is being acknowledged with athletes adapting their diet to optimise physical performance. This study aimed to examine the evidence for the relationship between consuming a predominately vegetarian diet and improved physical performance. Methods: A systematic literature review was undertaken using the SCOPUS database. No date parameters were set. The keywords; vegetarian* OR vegan* AND sport* OR athlete* OR training OR performance OR endurance’ were used. Included studies; (i) directly compared a vegetarian based diet to an omnivorous/mixed diet, (ii) directly assessed physical performance, not biomarkers of physical performance, (iii) did not use supplementation emulating a vegetarian diet. Reference lists were hand searched for additional studies. Results: Seven randomised controlled trials and one cross-sectional study met the inclusion criteria. No distinguished differences between vegetarian diets and omnivorous mixed diets were identified when physical performance was compared. Conclusions: Limited evidence is available to determine if consuming a predominately vegetarian diet will impact performance in athletes. Further research is warranted though the limited studies of this review did show no impact. Funding source(s): N/A. Abstracts / Journal of Nutrition & Intermediary Metabolism 4 (2016) 6e47 19

Arterial spin labeling (ASL) based cerebral blood flow (CBF) imaging complements blood oxygenation level dependent (BOLD) imaging with a measure that is more quantitative and has better specificity to neuronal activation. Relative to gradient echo (GE) BOLD, spin echo (SE) BOLD has better spatial specificity because it is less biased to large draining veins. While there have been many studies comparing simultaneously acquired CBF data with GE BOLD data in fMRI, there have been few studies comparing CBF with SE BOLD and no study comparing all three. We present a pulse sequence that simultaneously acquires CBF data with a separate labeling coil, GE BOLD and SE BOLD images. Simultaneous acquisition avoids inter-scan variability, allowing more direct assessment and comparison of each contrast’s relative specificity and reproducibility. Furthermore, it facilitates studies that may benefit from multiple complementary measures.

Humans consuming vegetarian-based diets are observed to have reduced relative risk for many chronic diseases. Similarly, regular physical activity has also been shown to assist in preventing, and reducing the severity of these conditions. Many people, including athletes, acknowledge these findings and are adopting a vegetarian-based diet to improve their health status. Furthermore, athletes are incorporating this approach with the specific aim of optimizing physical performance. To examine the evidence for the relationship between consuming a predominately vegetarian-based diet and improved physical performance, a systematic literature review was performed using the SCOPUS database. No date parameters were set. The keywords vegetarian OR vegan AND sport OR athlete OR training OR performance OR endurance were used to identify relevant literature. Included studies (i) directly compared a vegetarian-based diet to an omnivorous/mixed diet, (ii) directly assessed physical performance, not biomarkers of physical performance, and (iii) did not use supplementation emulating a vegetarian diet. Reference lists were hand searched for additional studies. Seven randomized controlled trials and one cross-sectional study met the inclusion criteria. No distinguished differences between vegetarian-based diets and omnivorous mixed diets were identified when physical performance was compared. Consuming a predominately vegetarian-based diet did not improve nor hinder performance in athletes. However, with only 8 studies identified, with substantial variability among the studies’ experimental designs, aims and outcomes, further research is warranted.

Highlights • Children with or without ADHD have moderate/high R-fMRI test–retest reliability. • Reliability is greater in controls than ADHD across most R-fMRI metrics. • Regional differences in ICC related to diagnostic groups reflect underlying pathophysiology for ADHD affecting both inter and intra subject variability., To date, only one study has examined test–retest reliability of resting state fMRI (R-fMRI) in children, none in clinical developing groups. Here, we assessed short-term test–retest reliability in a sample of 46 children (11–17.9 years) with attention-deficit/hyperactivity disorder (ADHD) and 57 typically developing children (TDC). Our primary test–retest reliability measure was the intraclass correlation coefficient (ICC), quantified for a range of R-fMRI metrics. We aimed to (1) survey reliability within and across diagnostic groups, and (2) compare voxel-wise ICC between groups. We found moderate-to-high ICC across all children and within groups, with higher-order functional networks showing greater ICC. Nearly all R-fMRI metrics exhibited significantly higher ICC in TDC than in children with ADHD for one or more regions. In particular, posterior cingulate and ventral precuneus exhibited group differences in ICC across multiple measures. In the context of overall moderate-to-high test–retest reliability in children, regional differences in ICC related to diagnostic groups likely reflect the underlying pathophysiology for ADHD. Our currently limited understanding of the factors contributing to inter- and intra-subject variability in ADHD underscores the need for large initiatives aimed at examining their impact on test–retest reliability in both clinical and developing populations.

Craddock C, et al. Towards Automated Analysis of Connectomes: The Configurable Pipeline for the Analysis of Connectomes. OHBM, 2013

Over more than three decades, The Anthony Nolan Trust (ANT) has provided an unrelated donor (UD) for over 4000 children and adults lacking a suitable family member donor, and has remained at the forefront of developments in haematopoietic stem cell transplantation (HSCT) and bone marrow register management. These three decades have seen major changes in clinical practice of UD-HSCT, including new indications, increased use of alternative haematopoietic cell sources, significant improvement of the outcome as a result of better support care, less-toxic conditioning regimens, and better donor selection, and expansion to older patients with higher comorbidities. In order to foster our goal of improving UD-HSCT availability and outcome in a progressively more complex clinical scenario, a new initiative from ANT was launched in 2005 to convene an experts workshop to address the topical issues in this field. Four consecutive panels addressed factors influencing donor selection and transplant outcome, the use of cord blood, regulatory and accreditation issues, and future developments in this field. This report summarizes the discussions held in this workshop, which will likely develop into a periodic event where transplant clinicians, scientists and registry members will meet to share their experience and vision in the field of UD-HSCT.

A 60-year-old man with Addison's disease, primary hypothyroidism and type 2 diabetes mellitus who was treated with stable doses of hydrocortisone and fludrocortisone developed increasing skin pigmentation and a bitemporal hemianopia. The plasma ACTH level was 14,464 pg/mL, and an invasive pituitary macroadenoma with suprasellar extension was found on magnetic resonance imaging leading to transnasal-transsphenoidal adenomectomy. The tumor demonstrated features of an eosinophilic adenoma and stained uniformly for ACTH. Residual tumor was treated with stereotactic radiotherapy. This case and the 13 cases published previously indicate that primary adrenal failure may predispose to corticotroph hyperplasia, and in some patients to the development of an invasive corticotroph adenoma. The ACTH level should be measured, and a pituitary magnetic resonance imaging is indicated when skin pigmentation increases in a patient with primary adrenal failure who is receiving customary treatment with glucocorticoids and mineralocorticoids.

Introduction: Allogeneic stem cell transplantation is a potentially curative option for patients with CML. The optimal donor is an HLA-identical sibling but transplants using unrelated volunteers can also be successful. The factors influencing survival after allogeneic SCT for CML are reasonably well defined. Recently however, the Seattle group have emphasised the influence of a high marrow cell dose on outcome following volunteer unrelated donor SCT for high risk acute leukaemia. Materials and methods: We have sought to define factors impacting on transplant related mortality (TRM) in a population of CML patients after allografting with matched sibling or alternative stem cell donors at a single centre over a 20-year period, with emphasis on infused marrow cell dose. Factors entered into a multivariate analysis were: recipient age, recipient CMV serostatus, disease phase, donor sex, cell dose and frequency of CTLP reactivity. Results: In multivariate analysis four factors had an adverse eAect on TRM when using a VUD: low marrow cell dose (53.65610 8 TNC/kg, relative risk 2.05, CI 1.08‐3.90, P=0.029), late disease phase (relative risk 1.68, CI 1.03‐2.74, P=0.038), patient CMV seropositivity (relative risk 1.98, CI 1.25‐3.13, P=0.004) and high frequency of CTLP (relative risk 1.93, CI 1.18‐3.13, P=0.008). For HLA-identical sibling donor transplants the only factor that adversely impacted on TRM was late disease phase (P=0.0004 in univariate analysis). Conclusion: High infused cell dose is a new modifiable factor associated with reduced TRM following allogeneic SCT using an unrelated donor for the treatment of CML. The data support the recommendation that bone marrow harvest teams should aim to collect the highest possible number of nucleated cells for recipients of unrelated donor transplants. The Hematology Journal (2001) 2, 265‐271