Should the standard dimethyl sulfoxide concentration be reduced? Results of a European Group for Blood and Marrow Transplantation prospective noninterventional study on usage and side effects of dimethyl sulfoxide.

Morris, Curly; de Wreede, Liesbeth; Scholten, Marijke; Brand, Ronald; van Biezen, Anja; Sureda, Anna; Dickmeiss, Ebbe; Trneny, Marek; Apperley, Jane; Chiusolo, Patrizia; van Imhoff, Gustaaf W; Lenhoff, Stig; Martinelli, Giovanni; Hentrich, Marcus; Pabst, Thomas; Onida, Francesco; Quinn, Michael; Kroger, Nicolaus; de Witte, Theo and Ruutu, Tapani (2014). Should the standard dimethyl sulfoxide concentration be reduced? Results of a European Group for Blood and Marrow Transplantation prospective noninterventional study on usage and side effects of dimethyl sulfoxide. Transfusion, 54(10), pp. 2514-2522. Wiley-Blackwell 10.1111/trf.12759

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BACKGROUND

Dimethyl sulfoxide (DMSO) is essential for the preservation of liquid nitrogen-frozen stem cells, but is associated with toxicity in the transplant recipient.

STUDY DESIGN AND METHODS

In this prospective noninterventional study, we describe the use of DMSO in 64 European Blood and Marrow Transplant Group centers undertaking autologous transplantation on patients with myeloma and lymphoma and analyze side effects after return of DMSO-preserved stem cells.

RESULTS

While the majority of centers continue to use 10% DMSO, a significant proportion either use lower concentrations, mostly 5 or 7.5%, or wash cells before infusion (some for selected patients only). In contrast, the median dose of DMSO given (20 mL) was much less than the upper limit set by the same institutions (70 mL). In an accompanying statistical analysis of side effects noted after return of DMSO-preserved stem cells, we show that patients in the highest quartile receiving DMSO (mL and mL/kg body weight) had significantly more side effects attributed to DMSO, although this effect was not observed if DMSO was calculated as mL/min. Dividing the myeloma and lymphoma patients each into two equal groups by age we were able to confirm this result in all but young myeloma patients in whom an inversion of the odds ratio was seen, possibly related to the higher dose of melphalan received by young myeloma patients.

CONCLUSION

We suggest better standardization of preservation method with reduced DMSO concentration and attention to the dose of DMSO received by patients could help reduce the toxicity and morbidity of the transplant procedure.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > DBMR Forschung Mu35 > Forschungsgruppe Med. Onkologie / Hämatologie (Erw.)
04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > DBMR Forschung Mu35 > Forschungsgruppe Med. Onkologie / Hämatologie (Erw.)

04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Medical Oncology

UniBE Contributor:

Pabst, Thomas

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0041-1132

Publisher:

Wiley-Blackwell

Language:

English

Submitter:

Marianne Zahn

Date Deposited:

10 Feb 2015 16:28

Last Modified:

11 Nov 2015 09:46

Publisher DOI:

10.1111/trf.12759

PubMed ID:

24964911

BORIS DOI:

10.7892/boris.62868

URI:

https://boris.unibe.ch/id/eprint/62868

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