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Reversible encephalopathy after cryopreserved peripheral blood stem cell infusion
M Dhodapkar1, S L Goldberg, A Tefferi
1Division of Hematology and Internal Medicine, Mayo Clinic, Rochester, Minnesota 55905.
American Journal of Hematology
|February 1, 1994
Summary
Severe encephalopathy occurred in two patients after receiving stem cells preserved in dimethylsulfoxide (DMSO). Plasmapheresis helped one patient recover, suggesting it may treat DMSO-related toxicity from stem cell infusions.
Area of Science:
- Hematology
- Neuroscience
- Toxicology
Background:
- Peripheral blood stem cell transplantation is a critical therapeutic modality.
- Cryopreservation of stem cells often utilizes dimethylsulfoxide (DMSO) as a cryoprotective agent.
- Understanding potential toxicities associated with cryopreservation agents is crucial for patient safety.
Observation:
- Two patients developed severe, reversible encephalopathy after receiving infusions of peripheral blood stem cells.
- The stem cells were cryopreserved using a solution containing 10% dimethylsulfoxide (DMSO).
Findings:
- Encephalopathy symptoms in one patient significantly improved after DMSO levels were reduced using plasmapheresis.
- This suggests a direct correlation between DMSO concentration and the observed neurological toxicity.
- The study highlights the potential for severe toxic reactions following the infusion of large volumes of cryopreserved stem cells.
Implications:
- Plasmapheresis may be a viable therapeutic option for managing severe DMSO-induced toxicity in stem cell transplant recipients.
- This finding warrants further investigation into safe DMSO concentration limits and alternative cryopreservation methods.
- Clinical protocols may need to incorporate monitoring for and management of DMSO-related neurological complications.