An automatic wash method for dimethyl sulfoxide removal in autologous hematopoietic stem cell transplantation decreases the adverse effects related to infusion

Transfusion. 2012 Nov;52(11):2382-6. doi: 10.1111/j.1537-2995.2012.03585.x. Epub 2012 Mar 8.

Abstract

Background: Products cryopreserved with dimethyl sulfoxide (DMSO) in stem cell transplant (SCT) often cause many adverse effects during their infusion (major cardiovascular events, dyspnea … even death). These are especially frequent in pediatric patients. We tested if a fully automated and closed wash procedure (Sepax S-100, Biosafe) allowed us to maintain the absolute CD34+ cell number, cell viability, and engraftment potential, decreasing the untoward reactions.

Study design and methods: Forty-six washes of DMSO cryopreserved peripheral blood hematopoietic progenitor (HP) apheresis were studied. Blood aliquots were taken both after thawing and after washing to assess the total nucleated and CD34+ cell counts, as well as cell viability. The washed products were infused in 26 autologous SCTs (ASCTs). Results were compared with the 53 previous SCTs performed without DMSO removal.

Results: After washing there were no significant differences between the pre- and postwashing CD34+ cell counts (p=0.08) or viability (p=0.68). No significant differences were observed between washed and nonwashed infusions in relation to the day of the neutrophil (p=0.46) and platelet (p=0.26) engraftment. One adverse event, abdominal pain, occurred during the washed cells infusions. When compared with the 14 untoward reactions that took place during the nonwashed HP infusions, significance was reached (p=0.00043).

Conclusions: The automatic method described is effective in terms of CD34+ cell recovery and viability in ASCT. Moreover, Sepax decreased significantly the untoward reactions during the infusion.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Aged
  • Blood Component Removal
  • Blood Preservation / adverse effects*
  • Blood Preservation / methods
  • Blood Transfusion, Autologous
  • Cell Survival / drug effects
  • Child
  • Child, Preschool
  • Cryoprotective Agents / adverse effects
  • Cryoprotective Agents / isolation & purification*
  • Dimethyl Sulfoxide / adverse effects
  • Dimethyl Sulfoxide / isolation & purification*
  • Female
  • Hematopoietic Stem Cell Transplantation / adverse effects
  • Hematopoietic Stem Cell Transplantation / standards*
  • Hodgkin Disease / therapy*
  • Humans
  • Lymphoma, Non-Hodgkin / therapy
  • Male
  • Middle Aged
  • Multiple Myeloma / therapy

Substances

  • Cryoprotective Agents
  • Dimethyl Sulfoxide