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Severe neurotoxicity because of dimethyl sulphoxide following peripheral blood stem cell transplantation

Bone Marrow Transplantation volume 31, page 315 (2003)Cite this article

EBMT data show that tens of thousands of autologous stem cell transplants have now been performed and it can be assumed that the vast majority of these will be peripheral blood or bone marrow cells preserved with dimethyl-sulphoxide (DMSO). Until recently, there has been little information on the neurological toxicity of this agent other than headache.1 The recent reports of Hoyt et al2 and Hequet et al3 suggest that this may be a more frequent problem than currently appreciated. In our unit, 208 peripheral blood and bone marrow autologous transplants have been performed between 1992 and March 2002, and we have also noted one episode of well-documented severe neurotoxicity attributed to DMSO.

The patient, a 55-year-old female with a 1 year history of IgA multiple myeloma with a partial response to four courses of cyclophosphamide, vincristine, adriamycin and methylprednisolone (C-VAMP) was also on Warfarin for a recent Hickman line-associated thrombosis and had no previous neurological toxicity. After cyclophosphamide priming, peripheral blood stem cells were frozen in autologous plasma with 10% DMSO and her transplant dose of 1.9×106 CD34+ cells/kg was contained in a total of four bags each of 100 ml. Conditioning chemotherapy was melphalan (200 mg/m2) and 24 h later the PBSCs were thawed and rapidly reinfused, one bag at a time. Premedication was with i.v. ondansetron (8 mg), hyoscine butylbromide (20 mg) and lorazepam (1 mg).

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References

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  1. Department of Haematology, Belfast City Hospital, Lisburn Road, Belfast, BT9 7AB, Northern Ireland

    P Windrum & T C M Morris

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Windrum, P., Morris, T. Severe neurotoxicity because of dimethyl sulphoxide following peripheral blood stem cell transplantation. Bone Marrow Transplant 31, 315 (2003). https://doi.org/10.1038/sj.bmt.1703848

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