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Summary:This study assessed the ability of recombinant human stem cell factor (rHuSCF) to mobilize stem cells in 44 patients who had failed a prior mobilization (CD34 + yield 0.5-1.9 Â 10 6 /kg BW) with filgrastim-alone or chemotherapyplus-filgrastim. The same mobilization regimen was used with the addition of rHuSCF. In the filgrastim-alone group (n ¼ 13), rHuSCF 20 lg/kg was started 3 days before filgrastim and continued for the duration of filgrastim. In the chemotherapy-plus-filgrastim group (n ¼ 31), rHuSCF 20 lg/kg/day plus filgrastim 5-10 lg/ kg/day were administered concurrently. Leukaphereses were continued to a maximum of four procedures or a target of X3 Â 10 6 CD34 + cells/kg. In both groups, CD34 + yield ( Â 10 6 /kg BW) of the study mobilization was higher than that of the prior mobilization (median: 2.42 vs 0.84 P ¼ 0.002 and 1.64 vs 0.99 P ¼ o0.001, respectively). In all 54 and 45% of patients in the filgrastim-alone group and chemotherapy-plus-filgrastim group, respectively, reached the threshold yield of 2 Â 10 6 / kg. The probability of a successful mobilization was the same in those with a CD34+ yield of 0.5-0.75 Â 10 6 /kg BW in the prior mobilization as in those with 0.76-1.99 Â 10 6 /kg BW. Downmodulation of c-kit expression and a lower percentage of Thy-1 positivity in the mobilized CD34 + cells were noted in the successful mobilizers compared with those in the poor mobilizers. This study shows that rhuSCF is effective in approximately half the patients who had failed a prior mobilization and allows them to proceed to transplant. It also points to the likely role of the SCF/c-kit ligand pair in mobilization.

Objectives To report our experience with ureteroscopic laser ablation of upper tract urothelial carcinoma (UTUC) in patients with Lynch Syndrome (LS), as defined by a documented germline mutation in the MSH‐2 gene. To increase awareness among urologists about UTUC in this unique patient population and refer to genetic counselling when appropriate. Patients and Methods Demographic, clinical and pathological data on 13 consecutive patients with UTUC and documented MSH‐2 mutation comprising 15 involved renal units were retrospectively collected. Ureteroscopic evaluations involved biopsy and laser treatment with combination holmium/neodymium yttrium aluminum garnet (YAG) lasers. Tumours were graded from 1 to 3 according to the 1973 World Health Organisation classification by a single pathologist evaluating cell block preparations. Results The mean patient age at initial presentation was 56.5 years, with six of 13 patients having metachronous bilateral UT disease. The mean follow‐up was 59 months with a mean number of surveillances of 12. Of 15 affected renal units, 10/15 (67%) of initial tumours involved the ureter with mean lesion size of 17.5 mm, while five of 15 (33%) involved the intrarenal collecting system with mean lesion size of 25 mm. Ureteroscopy cleared 13/15 (87%) lesions and four of those 13 (31%) needed staged procedures. Renal preservation rate was 14/15 (93%) with one nephroureterectomy and one segmental ureterectomy performed. One patient developed metastatic UTUC after 40 months surveillance. No patient presented with bladder tumours but seven of the 13 (54%) developed them within 10 months of the initial ureteroscopy. Conclusions Patients with LS who develop UTUC present at younger ages and appear to be more likely to have bilateral UT disease over their lifetimes vs sporadic UTUC patients. Ureteroscopic laser ablation offers a good renal preservation rate with reasonable cancer control in patients willing to undergo endoscopic surveillance. Development of new bladder tumours is common.

Publication of original research, clinical experiences, and critical reviews of literature are vital to the growth of the genetic counseling field, delivery of genetic counseling services, and professional development of genetic counselors. Busy clinical schedules, lack of time and funding, and training that emphasizes clinical skills over research skills may make it difficult for new genetic counselors to turn their thesis projects into publications. This paper summarizes and elaborates upon a presentation aimed at de-mystifying the publishing process given at the 2008 National Society of Genetic Counselors Annual Education Conference. Specific topics include familiarizing prospective authors, particularly genetic counseling students, with the basics of the publication process and related ethical considerations. Former students’ experiences with publishing master’s theses also are described in hopes of encouraging new genetic counselors to submit for publication papers based on their thesis projects.