Early enteral nutrition with fiber-containing solutions and living L plantarum 299 was well tolerated. It decreases markedly the rate of postoperative infections both in comparison with inactivated L plantarum 299 and significantly with SBD and a standard enteral nutrition formula. As it is a cheap and feasible alternative to SBD, further studies should evaluate whether this ecoimmunonutrition should be already started while patients are on the waiting list for transplantation.

Rituximab (IDEC-C2B8

months) for all patients. Conventional triple therapy was implemented in 25 patients, CsA-based quadruple induction therapy using an antilymphocyte globulin 1 Department of Surgery and Transplantation preparation (ATG) in 190 patients, an interleukin-2 receptor antibody (BT563) in Medicine, Virchow Medical Center, Humboldt 141 patients, and tacrolimus-based dual or triple immunosuppression in 102 paUniversity Berlin, Berlin, Germany.tients. The different protocols were evaluated in four randomized and two nonran-2 Department of Hematology/Oncology, Virchow domized prospective trials. Medical Center, Humboldt University Berlin, RESULTS.De novo neoplasias were detected in 33 patients (7.2%) and were comBerlin, Germany.prised of lymphomas (n Å 7), skin malignancies (n Å 8 lesions in 7 patients), intraepithelial neoplasias of the cervix uteri (n Å 7), breast carcinoma (n Å 3), lung carcinoma (n Å 3), and other malignancies (n Å 6). The incidence of de novo neoplasias did not differ in the different trial arms. Only a positive T-crossmatch and a low CD4 / /CD8 / ratio in patients receiving CsA-based immunosuppression demonstrated a significant correlation with the development of a de novo tumor in a multivariant logistic regression analysis. CONCLUSIONS. The development of de novo neoplastic diseases after liver trans-plantation with the use of CsA-based quadruple induction protocols or tacrolimusbased regimens for immunosuppresion was assessed over the long term. Recently introduced immunosuppressive protocols did not alter the posttransplant de novo tumor rate. Patients with a low CD4 / /CD8 / ratio during CsA-based therapy or a positive T-crossmatch were identified to be at an increased risk for the development of a de novo malignancy.

The need for a rapid and reliable marker for the engraftment potential of hematopoietic stem and progenitor cell (HPC) transplants has led to the development of flow cytometric assays to quantitate such cells on the basis of their expression of CD34. The variability associated with enumeration of low‐frequency cells (i.e., as low as 0.1% or 5 cells/μl) is exceedingly large, but recent developments have improved the accuracy and precision of the assay. Here, we review and compare the major techniques. Based on the current state of the art, we recommend 1) bright fluorochrome conjugates of class II or III monoclonal antibodies (mAbs) that detect all glycoforms of CD34, 2) use of a vital nucleic acid dye to exclude platelets, unlysed red cells, and debris or use of 7‐amino actinomycin D to exclude dead cells during data acquisition, 3) counterstaining with CD45 mAb to be included in the definition of HPC, 4) during list mode data analysis, Boolean gating to resolve the CD34+ HPCs from irrelevant cell populations on the basis of the low levels of CD45 expression and low sideward light‐scatter signals of HPCs, 5) inclusion of CD34dim and CD34bright populations in the CD34+ cell count, 6) omission of the negative control staining, and 7) for apheresis products, enumeration of at least 100 CD34+ cells to ensure a 10% precision. Unresolved technical questions are 1) the replacement of conventional dual‐platform by single‐platform assay formats, i.e., derivation of absolute CD34+ cell counts from a single flow cytometric assessment instead of from combined flow cytometer (percent CD34+) and hematology analyzer (absolute leukocyte count) data, 2) the cross‐calibration of the available single‐platform assays, and 3) the optimal method for sample preparation. An important clinical question to be addressed is the definition of the precise phenotypes and required numbers of HPCs responsible for short‐ and long‐term recovery to optimize HPC transplant strategies. Cytometry (Comm. Clin. Cytometry) 34: 128–142, 1998. © 1998 Wiley‐Liss, Inc.