Neurotoxicity upon infusion of dimethylsulfoxide-cryopreserved peripheral blood stem cells in patients with and without pre-existing cerebral disease.
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.
Mueller
Lutz P
LP
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.
Theurich
Sebastian
S
Christopeit
Maximilian
M
Grothe
Wilfried
W
Muetherig
Anke
A
Weber
Thomas
T
Guenther
Susanne
S
Behre
Gerhard
G
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
D004121:Dimethyl Sulfoxide