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Introduction With rapidly increasing demand, resources at cellular therapy centers may be stretched thin. Apheresis and processing lab facilities must meet increased collection, processing, and storage requests, necessitating efficiency. We queried the field's practice of collecting autologous stem cells for 2 transplants in adult multiple myeloma (MM) patients under 65 for efficiency and clinical relevance as MM collections consume significant cell therapy resources. Methods Data points from 2012, 2014, and 2016 for MM patients at DFCI were reviewed: percentage of patients who received first and second transplants after autologous collection, days of collection, and excess hematopoietic progenitor cell HPC(A) bags in cryostorage. MM clinician leadership discussed existing guidelines and clinical rationale for HPC(A) collection targets. After changes implemented in Feb. 2018, collection and storage data was compiled to assess impact. Apheresis & Cell Storage Data Prior to Change From Jul. to Dec. 2017, MM patients Clinical Practice Patterns & Change in Guidelines Before Feb. 2018, autologous MM collection target for patients Apheresis & Cell Storage Results Following Change Between Feb. – Jul. 2018, the total collection days for adult autologous MM patients Conclusion Reducing autologous collection targets for MM patients

In a pilot study, the polymerase chain reaction was found to be more sensitive than standard viral culture methods for the detection of cytomegalovirus, particularly from blood and tissues. We therefore applied this technique to 71 serially collected liver biopsies from 16 orthotopic liver transplant patients. All patients were CMV-seropositive (n = 15) or seroconverted (n = 1). Seven patients (9 biopsies) had histologically proved CMV hepatitis, and all these biopsies were CMV PCR-positive. Six of these 7 patients had a prior liver biopsy that was CMV PCR-positive, but culture and histology-negative, an average of 13.2 +/- 6.9 days before the histologically positive biopsy. The 7th patient was not biopsied prior to the diagnostic biopsy. Three patients had 7 liver biopsies that were CMV PCR-positive, but histologically negative for CMV hepatitis. Two of these three had CMV infection confirmed by viral culture of blood or liver biopsy. The remaining 6 patients had a total of 26 liver biopsies that were negative for CMV by PCR, culture, and histology. Among liver transplant patients, CMV PCR performed on liver biopsy specimens correctly identified all histologically proven cases of CMV hepatitis. CMV PCR positivity in liver tissue did not correlate with latent infection and preceded the development of CMV hepatitis or other meaningful CMV infection in 8 of 10 patients.