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Neurotoxicity upon infusion of dimethylsulfoxide‐cryopreserved peripheral blood stem cells in patients with and without pre‐existing cerebral disease
Author(s) -
Mueller Lutz P.,
Theurich Sebastian,
Christopeit Maximilian,
Grothe Wilfried,
Muetherig Anke,
Weber Thomas,
Guenther Susanne,
Behre Gerhard
Publication year - 2007
Publication title -
european journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 84
eISSN - 1600-0609
pISSN - 0902-4441
DOI - 10.1111/j.1600-0609.2007.00851.x
Subject(s) - neurotoxicity , medicine , toxicity , disease , adverse effect , pediatrics
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.