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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 and Chiusolo, Patrizia, et al. (2014) In Transfusion 54(10). p.2514-2522
Abstract
BackgroundDimethyl 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 MethodsIn 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. ResultsWhile 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 (20mL) was much less than the... (More)
BackgroundDimethyl 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 MethodsIn 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. ResultsWhile 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 (20mL) was much less than the upper limit set by the same institutions (70mL). 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. ConclusionWe 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. (Less)
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Transfusion
volume
54
issue
10
pages
2514 - 2522
publisher
Wiley-Blackwell
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  • wos:000343813900021
  • scopus:84908101326
ISSN
1537-2995
DOI
10.1111/trf.12759
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English
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2a5eeb3e-85e7-4bf8-996b-6422bd9bf786 (old id 4879078)
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2015-01-07 10:29:08
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@article{2a5eeb3e-85e7-4bf8-996b-6422bd9bf786,
  abstract     = {BackgroundDimethyl 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 MethodsIn 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. ResultsWhile 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 (20mL) was much less than the upper limit set by the same institutions (70mL). 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. ConclusionWe 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.},
  author       = {Morris, Curly and de Wreede, Liesbeth and Scholten, Marijke and Brand, Ronald and van Biezen, Anja and Sureda, Anna and Dickmeiss, Ebbe and Trneny, Marek and Apperley, Jane and Chiusolo, Patrizia and van Imhoff, Gustaaf W. and Lenhoff, Stig and Martinelli, Giovanni and Hentrich, Marcus and Pabst, Thomas and Onida, Francesco and Quinn, Michael and Kroger, Nicolaus and de Witte, Theo and Ruutu, Tapani},
  issn         = {1537-2995},
  language     = {eng},
  number       = {10},
  pages        = {2514--2522},
  publisher    = {Wiley-Blackwell},
  series       = {Transfusion},
  title        = {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},
  url          = {http://dx.doi.org/10.1111/trf.12759},
  volume       = {54},
  year         = {2014},
}