Oncology Nurses’ Experience of Dimethyl Sulfoxide Odor

Abstract

This article presents findings of an exploratory descriptive study on the effects of dimethyl sulfoxide (DMSO) odor in an oncology unit. The nursing staff, who had reported their concerns about the unpleasant odor emitted from patients undergoing peripheral stem cell transplantation, initiated the study. A literature review revealed some evidence of the possible ill effects on staff caring for patients having DMSO treatment, but many questions remain unanswered such as what staff experience in dealing with DMSO odor and whether nursing care is affected in any way? Data were collected through interviews with 22 oncology nurses who all had experienced direct and indirect exposure to DMSO odor. Of the 22 nurses interviewed, 20 reported that they found DMSO odor unpleasant and reported experiencing physical symptoms such as headaches and gastrointestinal reactions. The study also revealed a situation in which nurses described odor avoidance and distancing strategies that potentially compromised the nurse-patient relationship.

Orange Interventions for Symptoms Associated With Dimethyl Sulfoxide During Stem Cell Reinfusions

“…Patient, family, and staff may experience throat irritation, coughing, nausea, and headache. 6 Excreted DMSO metabolites produce an intense, noxious odor, commonly described as smelling like garlic or creamed corn. 8 The serum half-life is approximately 20 hours, although the odor may linger for 24 hours or longer, depending on the number bags of cells, total infused volume, and concentration of DMSO.…”

No Differences in Colony Formation of Peripheral Blood Stem Cells Frozen with 5% or 10% Dimethyl Sulfoxide

“…All patients showed satisfactory hematopoietic reconstitution with platelet counts exceeding 50 3 10 9 /L within 20 days (range [11][12][13][14][15][16][17][18][19][20] and granulocyte counts .0.5 3 10 9 /L within 20 days (range 9-20) after autotransplantation.…”

“…About 45% of injected DMSO is secreted through the urine, whereas DMS is secreted through the skin, breath, feces, and urine from the patients for up to 2 days after infusion. Thus, DMSO toxicity can be a problem for several days after stem cell infusion (16).…”

Are orange lollies effective in preventing nausea and vomiting related to dimethyl sulfoxide? A multicenter randomized trial

“…Reinfusion may have several side effects such as hemolysis, anaphylactic reactions, kidney failure, high systolic and diastolic blood pressure, bradycardia. However, gastrointestinal problems are the most frequent, particularly nausea and vomiting (NV), partly related to the characteristic garlic-like breath due to pulmonary excretion of the cryopreservative [3,4,5,6]. DMSO and its metabolites (dimethylsulfone and dimethylsulfide), are excreted over the 24 hours after infusion, through urine, skin and breathing [3].…”

“…The smell and flavor of orange may reduce the patient's perception of its odor [5,6] and thus NV (an unpleasant odor can be masked by a pleasant one [13,14]) although studies have given conflicting results. This suggested the hypothesis that DMSO-evoked activity map (odor map) might be inhibited by activation of mitral cells in the neighboring orange-responsive clusters.…”