Haematological engraftment was assessed in 804 autologous transplants. Neutrophil recovery occurred in over 99% within 14 d but platelet recovery was delayed beyond this time in 14·8%. Time to recovery was dependent on the progenitor cell dose infused. The minimum CD34 cell threshold adopted in this study (2 × 10 /kg) was safe although recovery was faster with a dose >5 × 10 /kg. CD34 cell doses of between 1 and 2 × 10 /kg were also acceptable if either the granulocyte-macrophage colony-forming cell dose exceeded 2 × 10 /kg or this dose was due to splitting a higher yield harvest. Prompt neutrophil recovery affords important quality assurance for laboratory processing.

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A 38-year-old right-hand dominant male mechanic with uncontrolled diabetes mellitus type I presented to the emergency department (ED) complaining of worsening pain and swelling in his right hand. In the ED, a computed tomography scan confirmed the presence of soft-tissue edema in the right arm, but necrotizing fasciitis (NF) was not initially considered as a diagnosis. His Laboratory Risk Indicator for NF (LRINEC) score at the time of his hospitalization was 4, indicating a less than 50% chance of NF. Within 12 hours of admission, he developed increased violaceous, nonblanching skin of his dorsal fingers, increased swelling in his hand and forearm, bullae development in his palm and index finger, and a high fever. His LRINEC score had increased to 7, making NF up to 75% likely. He was urgently taken to the operating room (OR) for extensive debridement then admitted to the intermediate care unit for medical stabilization. He was subsequently taken back to the OR for serial debridements, and a negative pressure wound therapy device was placed once the wound was successfully debrided down to viable tissue. This is a case study of the multidisciplinary approach taken to the very ill patient at a community military hospital.