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.
abstract: BACKGROUND
  Dimethyl sulfoxide (DMSO) is essential for the preservation of liquid nitrogen-frozen stem cells, but is associated with toxicity in the transplant recipient.
  
  
  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.
  
  
  CONCLUSIONS
  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.
authors: Centre for Cancer Research and Cell Biology, Queen's University of Belfast, Belfast, UK.
authors: Curly
authors: C
authors: Morris
authors: Liesbeth
authors: L
authors: de Wreede
authors: Marijke
authors: M
authors: Scholten
authors: Ronald
authors: R
authors: Brand
authors: Anja
authors: A
authors: van Biezen
authors: Anna
authors: A
authors: Sureda
authors: Ebbe
authors: E
authors: Dickmeiss
authors: Marek
authors: M
authors: Trneny
authors: Jane
authors: J
authors: Apperley
authors: Patrizia
authors: P
authors: Chiusolo
authors: Gustaaf W
authors: GW
authors: van Imhoff
authors: Stig
authors: S
authors: Lenhoff
authors: Giovanni
authors: G
authors: Martinelli
authors: Marcus
authors: M
authors: Hentrich
authors: Thomas
authors: T
authors: Pabst
authors: Francesco
authors: F
authors: Onida
authors: Michael
authors: M
authors: Quinn
authors: Nicolaus
authors: N
authors: Kroger
authors: Theo
authors: T
authors: de Witte
authors: Tapani
authors: T
authors: Ruutu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001793:Blood Preservation / Q000379:methods / Q000592:standards*; D001854:Bone Marrow Cells; D015925:Cryopreservation / Q000379:methods / Q000592:standards*; D003451:Cryoprotective Agents / Q000009:adverse effects / Q000494:pharmacology*; D004121:Dimethyl Sulfoxide / Q000009:adverse effects / Q000494:pharmacology* / Q000592:standards; D004305:Dose-Response Relationship, Drug; D005060:Europe; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects / Q000379:methods; D006412:Hematopoietic Stem Cells; D006801:Humans; D008297:Male; D008875:Middle Aged; D009994:Osmolar Concentration; D065227:Transfusion Reaction / Q000453:epidemiology; D014182:Transplantation, Autologous; D055815:Young Adult
chemical_list: D003451:Cryoprotective Agents; D004121:Dimethyl Sulfoxide