Hematopoietic engraftment of dimethyl sulfoxide-depleted autologous peripheral blood progenitor cells.
BACKGROUND
Autologous stem cell transplantation with cryopreserved autografts is a prerequisite for high-dose chemotherapy in treatment of several malignancies. Adverse effects due to the cryoprotectant dimethyl sulfoxide (DMSO) vary from mild to severe. DMSO-associated adverse effects can be reduced by DMSO depletion before autograft infusion. The aim was to investigate whether DMSO depletion by manual single wash reduced frequency of adverse effects or had detrimental effects on the engraftment potential of peripheral blood progenitor cell (PBPC) autografts.


METHODS
Ten percent DMSO was used to cryopreserve PBPC autografts for a total of 53 patients with multiple myeloma (n = 41), non-Hodgkin's lymphoma (n = 8), amyloidosis (n = 3), and polyneuropathy, organomegaly, endocrinopathy, M protein, and skin changes (POEMS) syndrome (n = 1). After high-dose chemotherapy, 34 patients received unmanipulated autografts, whereas for 19 patients the autografts were manually washed before stem cell infusion. Adverse effects after the infusion as well as neutrophil (neutrophil count >0.5 x 10(9)/L) and platelet (PLT) engraftment (PLT count >20 x 10(9)/L) for these two groups were compared.


RESULTS
DMSO depletion reduced the frequency of adverse effects significantly. Patients transplanted with DMSO-depleted autografts had similar neutrophil engraftment time as patients receiving unmanipulated autografts. PLT engraftment time, however, was significantly prolonged and PLT transfusion requirements significantly increased for patients receiving DMSO-depleted autografts, even though the numbers of infused CD34+ cells per kg did not differ between the groups.


CONCLUSIONS
DMSO depletion through a manual single wash is a time-consuming procedure that reduces adverse effects. Although the procedure leads to an increase of 2 days in PLT engraftment time, it can be recommended for selected patients with high risk of serious DMSO toxicity.
Akkök
Ciğdem A
CA
Department of Immunology and Transfusion Medicine, the Centre of Clinical Research, Ullevaal University Hospital, Oslo, Norway. ciak@uus.no
Holte
Mette R
MR
Tangen
Jon M
JM
Ostenstad
Bjørn
B
Bruserud
Oystein
O
D000328:Adult; D000686:Amyloidosis / Q000276:immunology / Q000628:therapy; D001793:Blood Preservation / Q000009:adverse effects; D003451:Cryoprotective Agents / Q000009:adverse effects*; D004121:Dimethyl Sulfoxide / Q000009:adverse effects*; D005260:Female; D006085:Graft Survival / Q000276:immunology; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D007958:Leukocyte Count; D008228:Lymphoma, Non-Hodgkin / Q000276:immunology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000276:immunology / Q000628:therapy; D009504:Neutrophils / Q000166:cytology; D016878:POEMS Syndrome / Q000276:immunology / Q000628:therapy; D010976:Platelet Count; D013997:Time Factors; D019172:Transplantation Conditioning / Q000379:methods; D014182:Transplantation, Autologous / Q000276:immunology; D016896:Treatment Outcome
D003451:Cryoprotective Agents; D004121:Dimethyl Sulfoxide