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Ischemic stroke associated with the infusion of DMSO-cryopreserved auto-PBSCs

Bone Marrow Transplantation volume 46, pages 1035–1036 (2011)Cite this article

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DMSO is used as a cryoprotectant for long-term storage of auto-PBSCs. It is considered to be relatively safe, although several side effects have been associated with its infusion, including nausea, vomiting, chills, rigors, flushing, fever, dyspnea, anaphylaxis and cardiovascular events, such as bradyarrhythmia or hypotension. Central nervous system-related complications after DMSO administration during auto-PBSC transplantation are rare, headache being the most common. We would like to report one case of ischemic stroke during the administration of DMSO-cryopreserved auto-PBSC.

A 57-year-old male was admitted to our institution for undergoing auto-SCT. He had neither hypertension nor diabetes, although mild hypertriglyceridemia had been detected in a routine test, which was controlled with diet and regular physical exercise. In addition, he had been a smoker of 20 cigarettes per day until 2005. Our patient was diagnosed of IgA Kappa multiple myeloma, stage IIA, ISS2 in June 2008. The patient was treated with six cycles of combination polychemotherapy with VBCMP (VCR, BCNU, CY, melphalan and prednisone) and VBAD (VCR, BCNU, adriamycin and dexamethasone) achieving a very good partial response (positive immunofixation) in January 2009. PBSC were collected by leukapheresis after the fourth cycle of chemotherapy. Mobilization was performed with G-CSF 5 μg/kg/12 h, and the number of collected cells after one session of apheresis was 2.4 × 106 CD34+ cells/kg (10.97 × 108 nucleated cells/kg) in a final vol of 214 mL. Cells were cryopreserved in 10% DMSO (36 mL) with 30% fresh frozen plasma (110 mL) and stored in liquid nitrogen at −150 °C. Final total vol cryopreserved was 360 mL in two bags, with approximately 18 g of DMSO per bag (0.28 g per kg DMSO per bag).

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References

  1. Marcacci G, Corazzelli G, Becchimanzi C, Arcamone M, Capobianco G, Russo F et al. DMSO-associated encephalopathy during autologous peripheral stem cell infusion: a predisposing role of preconditioning exposure to CNS-penetrating agents? Bone Marrow Transplant 2009; 44: 133–135.

    Article  CAS  Google Scholar 

  2. Hoyt R, Szer J, Grigg A . Neurological events associated with the infusion of cryopreserved bone marrow and/or peripheral blood progenitor cells. Bone Marrow Transplant 2000; 25: 1285–1287.

    Article  CAS  Google Scholar 

  3. Windrum P, Morris TC . Severe neurotoxicity because of dimethyl sulphoxide following peripheral blood stem cell transplantation. Bone Marrow Transplant 2003; 31: 315.

    Article  CAS  Google Scholar 

  4. Hentschke S, Hentschke M, Hummel K, Salwender HJ, Braumann D, Stang A . Bilateral thalamic infarction after reinfusion of DMSO-preserved autologous stem-cells. Leuk Lymphoma 2006; 47: 2418–2420.

    Article  Google Scholar 

  5. Otrock ZK, Beydoun A, Barada WM, Masroujeh R, Hourani R, Bazarbachi A . Transient global amnesia associated with the infusion of DMSO-cryopreserved autologous peripheral blood stem cells. Haematologica 2008; 93: e36–e37.

    Article  Google Scholar 

  6. Mueller LP, Theurich S, Christopeit M, Grothe W, Muetherig A, Weber T . Neurotoxicity upon infusion of dimethylsulfoxide-cryopreserved peripheral blood stem cells in patients with and without pre-existing cerebral disease. Eur J Haematol 2007; 78: 527–531.

    Article  CAS  Google Scholar 

  7. Junior AM, Arrais CA, Saboya R, Velasques RD, Junqueira PL, Dulley FL . Neurotoxicity associated with dimethylsulfoxide-preserved hematopoietic progenitor cell infusion. Bone Marrow Transplant 2008; 41: 95–96.

    Article  CAS  Google Scholar 

  8. Abdelfeki A, Lakhal A, Moojat N, Ben Hamed L, Fekih J, Ladeb S et al. Severe neurotoxicity associated with dimethyl sulphoxide following PBSCT. Bone Marrow Transplant 2009; 44: 323–324.

    Article  Google Scholar 

  9. Abrahamsen Foss J, Bakken A, Broservd O . Freezing human peripheral blood progenitor cells with 5 rather than 10% DMSO produces less apoptosis and necrosis in CD34+ cells post thaw. Bone Marrow Transplant 2002; 29 (Suppl. 2): 142.

    Google Scholar 

  10. Chen-Plotkin AS, Vossel KA, Samuels MA, Chen MH . Encephalopathy, stroke and myocardial infarction with DMSO use in stem cell transplantation. Neurology 2007; 68: 859–861.

    Article  Google Scholar 

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Authors and Affiliations

  1. Servicio de Hematología, Hospital Universitario de Salamanca, Salamanca, Spain

    T J González-López, F M Sánchez-Guijo, E Crusoe, I Cordoba, M Corral, L Vazquez & M D Caballero

  2. Servicio de Neurología, Hospital Universitario de Salamanca, Salamanca, Spain

    A Ortín

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  1. T J González-López
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  2. F M Sánchez-Guijo
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  3. A Ortín
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  4. E Crusoe
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Correspondence to F M Sánchez-Guijo.

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González-López, T., Sánchez-Guijo, F., Ortín, A. et al. Ischemic stroke associated with the infusion of DMSO-cryopreserved auto-PBSCs. Bone Marrow Transplant 46, 1035–1036 (2011). https://doi.org/10.1038/bmt.2010.242

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