Cryopreserved stem cell products containing dimethyl sulfoxide lead to activation of the coagulation system without any impact on engraftment

Abstract

Infusion of stem cells containing DMSO reversibly activated coagulation, measured as thrombin generation. This finding was not associated with acute adverse events and did not influence engraftment. Further studies are needed to compare variable DMSO concentrations as well as DMSO-free products, to better address the influence of DMSO on hemostasis.

The value of the post‐thaw CD34+ count with and without DMSO removal in the setting of autologous stem cell transplantation

“…[6][7][8][9] A wide range of adverse events (AEs) are described upon infusion of cryopreserved stem cells products, from simple nausea/vomiting, diarrhea, flushing, and chills to severe and even life-threatening cardiovascular, renal, and neurologic reactions. 8,[10][11][12] Some studies suggested a dosedependent effect of DMSO on the occurrence of AEs, 7,[13][14][15][16] and recommendations for a maximum daily DMSO dose have been pusblished. 12 In an effort to reduce infusion-related AEs, much research was conducted on finding the optimal concentration of DMSO minimizing the occurrence of AEs upon infusion while maximizing the viability of stem cells during cryopreservation, and concentrations as low as 2.5% DMSO were tested.…”

“…Currently, dimethyl sulfoxide (DMSO) in a concentration of 5% to 10% is widely used as cryoprotectant in stem cell preservation . A wide range of adverse events (AEs) are described upon infusion of cryopreserved stem cells products, from simple nausea/vomiting, diarrhea, flushing, and chills to severe and even life‐threatening cardiovascular, renal, and neurologic reactions . Some studies suggested a dose‐dependent effect of DMSO on the occurrence of AEs, and recommendations for a maximum daily DMSO dose have been pusblished .…”

Reações adversas no dia zero do transplante de células-tronco hematopoéticas: revisão integrativa

“…As for the source of the hematopoietic stem cells used, a study from the United Kingdom did not reveal which source was used in the HSCT (29) . In 13 studies, the source of the HSC was peripheral blood (5,12,(18)(19)21,(23)(24)(25)(26)(27)(28)(29)32) . A Turkish study used only bone marrow (33 ) and another Japanese study only the umbilical cord and the placental blood (22) .…”

“…Eleven of the 18 studies reported toxicity due to the Dimethyl sulfoxide preservative (18)(19)(20)(23)(24)(25)(27)(28)30,(32)(33) , and its relation with several adverse reactions. Some suggest limiting the daily infused dose of DMSO, which could be achieved with a lower concentration of this preservative in the freezing, or with an infusion division over multiple days (18,20,30) .…”

“…Regarding the classification of adverse reactions, 10 studies did not perform the classification (12,(18)(19)(20)23,(27)(28)(29)(32)(33) . Three classified the AR by degree of severity (21,24,31) .…”