title: Neurotoxicity upon infusion of dimethylsulfoxide-cryopreserved peripheral blood stem cells in patients with and without pre-existing cerebral disease.
abstract: OBJECTIVE
  Toxicity related to the infusion of dimethylsulfoxide (DMSO)-cryopreserved peripheral blood stem cells (DMSO-PBSC) mainly comprises cardiovascular events. Fatal neurotoxicity has been reported in a few cases. DMSO represents the putative causative agent of such rare toxicities and elaborate strategies to replace DMSO would benefit from the identification of predisposing factors for DMSO-related toxicities.
  
  
  METHODS
  Here, we report on DMSO-related neurotoxicity in a series of patients (n = 51) receiving DMSO-PBSC. The analyzed patient-series included eight patients with pre-existing cerebral disease, partially with a history of epileptic seizures.
  
  
  RESULTS
  Neurotoxicity was observed in only one patient who suffered from a generalized tonic seizure upon infusion of DMSO-PBSC and for which the clinical course is reported herein. No neurotoxicity was observed in the group of patients with pre-existing neurological disease. Furthermore, no neurotoxicity was observed in patients who received particularly large volumes of DMSO. In all patients, mild non-neurological side effects occurred but besides the reported seizure no other severe adverse events were observed upon PBSC-infusion.
  
  
  CONCLUSIONS
  To our knowledge, this is the first report addressing the identification of predisposing factors for DMSO-related neurotoxicty. We conclude that infusion of DMSO-PBSC can be performed safely in patients with pre-existing cerebral disease despite the rare occurrence of severe neurotoxicity. Retrospective multicenter studies are warranted to identify patients who would benefit from elaborate methods of DMSO-replacement.
authors.affiliation: Bone Marrow Transplantation Section, Department of Internal Medicine IV--Hematology and Oncology, State Center for Cell and Gene Therapy, Martin-Luther-University Halle-Wittenberg, Halle, Germany.
authors.forename: Lutz P
authors.initials: LP
authors.lastname: Mueller
authors.forename: Sebastian
authors.initials: S
authors.lastname: Theurich
authors.forename: Maximilian
authors.initials: M
authors.lastname: Christopeit
authors.forename: Wilfried
authors.initials: W
authors.lastname: Grothe
authors.forename: Anke
authors.initials: A
authors.lastname: Muetherig
authors.forename: Thomas
authors.initials: T
authors.lastname: Weber
authors.forename: Susanne
authors.initials: S
authors.lastname: Guenther
authors.forename: Gerhard
authors.initials: G
authors.lastname: Behre
mesh_terms: D000328:Adult; D000368:Aged; D001927:Brain Diseases / Q000628:therapy*; D015925:Cryopreservation; D004121:Dimethyl Sulfoxide / Q000633:toxicity*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D033581:Stem Cell Transplantation
chemical_list: D004121:Dimethyl Sulfoxide