Variation in dimethyl sulfoxide use in stem cell transplantation: a survey of EBMT centres

Windrum, P; Morris, T. C. M.; Drake, Mary; Niederwieser, D.; Ruutu, Tapani

doi:10.1038/sj.bmt.1705100

Cited by 176 publications

(175 citation statements)

References 13 publications

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“…33 DMSO-related cardiac toxicity is rare and there have recently been questions regarding the causative relationship between DMSO and these events. 34 Recent reports of similar acute cardiac events despite DMSO depletion have led to the suggestion that perhaps the complications seen following infusion may be more a product of the amount of infused granulocytes, rather than DMSO. 11 Lastly, infectious complications during early post-transplant neutropenia or prolonged immunosuppression for GVHD prophylaxis are a common problem following HCT.…”

Section: Cardiovascular Disease After Hematopoietic Cell Transplantatmentioning

confidence: 99%

“…11 Conditioning-related risk factors potentially include: high-dose cyclophosphamide, 32 total body irradiation, 33 presence of dimethyl sulphoxide (DMSO) in the transfused product, 34 and infectious complications during early post-transplant neutropenia.…”

Section: 31mentioning

confidence: 99%

“…8,9 Cardiac complications associated with exposure to conditioning regimens are often acute, with relatively short latency. 11 Conditioning-related risk factors potentially include: high-dose cyclophosphamide, 32 total body irradiation, 33 presence of dimethyl sulphoxide (DMSO) in the transfused product, 34 and infectious complications during early post-transplant neutropenia.…”

Section: Cardiovascular Disease After Hematopoietic Cell Transplantatmentioning

confidence: 99%

“…34 Recent reports of similar acute cardiac events despite DMSO depletion have led to the suggestion that perhaps the complications seen following infusion may be more a product of the amount of infused granulocytes, rather than DMSO.…”

mentioning

confidence: 99%

“…28 However, the prevalence of these co-morbidities following HCT 14,15 potentially increases the magnitude of risk for premature cardiovascular disease among HCT survivors -an observation that has now been confirmed for arterial outcomes 10 and CHF. 8,9 Cardiac complications associated with exposure to conditioning regimens are often acute, with relatively short latency.11 Conditioning-related risk factors potentially include: high-dose cyclophosphamide, 32 total body irradiation, 33 presence of dimethyl sulphoxide (DMSO) in the transfused product, 34 and infectious complications during early post-transplant neutropenia.The risk associated with high-dose cyclophosphamide is dose-dependent and characterized by cardiac muscle damage, and subsequent necrosis. Congestive heart failure can occur within weeks of administration of high-dose cyclophosphamide and disease manifestations may be worse in individuals with pre-existing cardiac compromise.…”

mentioning

confidence: 99%

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Cardiovascular disease after hematopoietic cell transplantation - lessons learned

Armenian¹,

Bhatia²

2008

Haematologica

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H ematopoietic cell transplantation (HCT) has now become the treatment of choice for a large number of malignant and non-malignant diseases.1 It is quite clear that unless effective targeted therapy becomes available, HCT will continue to be offered as a curative therapeutic modality to patients diagnosed with a variety of malignant and non-malignant disorders. Among those who survive the first 2 years, nearly 80% of allogeneic HCT recipients 2,3 and 70% of autologous HCT recipients 4 are expected to become long-term survivors, with an attendant growth in such survivors. Due to improvements in survival rate, major issues for patients undergoing HCT have expanded to include the care and management of survivors, prevention of adverse outcomes, and maintenance of a good health-related quality of life. Some of the well-described complications in this population include subsequent malignancies, cataracts, pulmonary complications, endocrine dysfunction, osteonecrosis, chronic kidney disease, and impairment in functional status due to persistent, chronic graft-versus-host disease (GVHD).5-7 Details regarding cardiovascular dysfunction after HCT are now emerging. [8][9][10] In this issue of the journal, Tichelli et al. publish the results of their retrospective study designed to describe the magnitude of risk of and associated risk factors for the development of arterial events after allogeneic HCT. 10 The events of interest include coronary artery disease, cerebrovascular disease and peripheral artery disease. They report that the cumulative incidence of arterial events at 15 years is 6%, and identify older age at the time of HCT and presence of pre-established cardiovascular risk factors (diabetes, obesity, dyslipidemia, arterial hypertension) as being associated with an increased risk of these outcomes.In a recent study, we used a nested case-control study design to examine the independent role of pre-HCT exposure to therapeutic agents, transplant-related conditioning and co-morbidities in the development of congestive heart failure (CHF) after HCT. 8,9 We identified pre-HCT exposure to anthracyclines and the presence of post-HCT co-morbidities as being associated with delayed CHF after HCT.The best-described therapy-related late cardiac complications include valvular dysfunction, conduction abnormalities, pericarditis, and cardiomyopathy. [11][12][13] Arterial complications can occur as a result of damage to the entire vascular system and include coronary artery disease, cerebrovascular disease, and peripheral artery disease.14,15 While the latency period for many of these diseases can be short, survivors often do not have clinical evidence of disease until several years following HCT.14-16 As with most other complications observed after HCT, cardiovascular complications following HCT are due, in part, to the treatment prior to, during, and following HCT.Age at therapeutic exposure, gender, and past medical history are important considerations when identifying the potential risk of long-term cardiovascular disease. ...

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Section: Cardiovascular Disease After Hematopoietic Cell Transplantatmentioning

confidence: 99%

Section: 31mentioning

confidence: 99%