Umbilical cord blood transplantation using nonmyeloablative conditioning is currently considered by many as a valid potential alternative for any patient who requires an unrelated donor allograft and who is without a suitably matched and readily available volunteer. Dimethyl sulfoxide (DMSO) has been used for years as a cryoprotectant agent; it acts by penetrating the cell and binding water molecules and it has been described as harmless for the individual who receives it in limited amounts. In this paper, we describe 3 cases of DMSO-induced toxicities and briefly review the most common adverse reactions of the DMSO when used as a cryopreservation agent for the long-term storage of cord blood cells. Two of the 3 cases had a dismal prognosis. A brief review of the literature is presented.

1.
Gluckman E, Rocha V, Arcese W, Michel G, Sanz G, Chan KW, Takahashi TA, Ortega J, Filipovich A, Locatelli F, Asano S, Fagioli F, Vowels M, Sirvent A, Laporte JP, Tiedemann K, Amadori S, Abecassis M, Bordigoni P, Diez B, Shaw PJ, Vora A, Caniglia M, Garnier F, Ionescu I, Garcia J, Koegler G, Rebulla P, Chevret S, Eurocord Group: Factors associated with outcomes of unrelated cord blood transplant: guidelines for donor choice. Exp Hematol 2004;32:397–407.
2.
Schaefer VW, Dicke KA: Preservation of hemopoietic stem cells. Transplantation potential and CFU-C activity of frozen marrow tested in mice, monkeys and man; in Weiner R (ed): Cryopreservation of Normal and Neoplastic Cells. Paris, INSERM, 1973, p 63.
3.
Mancías-Guerra C, Ruiz-Delgado GJ, Manzano C, Díaz-Hernandez MA, Tarín-Arzaga LC, González-Llano O, Gómez-Almaguer D, Ruiz-Argüelles GJ: Umbilical cord blood transplantation using non-myeloablative conditioning: the Mexican experience. Hematology 2006;11:355–359.
4.
Santos NC, Prieto MJE, Morna-Gomes A, Betbeder D, Castanho MARB: Structural characterization (shape and dimensions) and stability of polysaccharide/lipid nanoparticles. Biopolymers 1997;41:511–520.
5.
Parkin J, Shea C, Sant GR: Intravesical dimethyl sulfoxide (DMSO) for interstitial cystitis – a practical approach. Urology 1997;49:105–107.
6.
Stout L, Gerspach JM, Levy SM, Yun SK, Lad PM, Leach GE, Zimmern PE: Dimethyl sulfoxide does not trigger urine histamine release in interstitial cystitis. Urology 1995;46:653–656.
7.
Burgess JL, Hamner AP, Robertson WO: Sulfhemoglobinemia after dermal application of DMSO. Int J Dermatol 1998;37:949–954.
8.
Wong CK, Lin CS: Remarkable response of lipoid proteinosis to oral dimethyl sulphoxide. Br J Dermatol 1988;119:541–544.
9.
Hsieh SD, Yamamoto R, Saito K, Iwamoto Y, Kuzuya T, Ohba S, Kobori S, Saito K: Amyloidosis presented with whitening and loss of hair which improved after dimethyl sulfoxide (DMSO) treatment. Jpn J Med 1987;26:393–395.
10.
McCammon KA, Lentzner NA, Moriarty RP, Schellhammer PF: Intravesical dimethyl sulfoxide for primary amyloidosis of the bladder. Urology 1998;52:1136–1138.
11.
Iwasaki T, Hamano T, Aizawa K, Kobayashi K, Kakishita E: A case of pulmonary amyloidosis associated with multiple myeloma successfully treated with dimethyl sulfoxide. Acta Haematol 1994;91:91–94.
12.
Morassi P, Massa F, Mesesnel E, Magris D, D’Agnolo B: Treatment of amyloidosis with dimethyl sulfoxide (DMSO). Minerva Med 1989;80:65–70.
13.
Salim AS: Role of oxygen-derived free radical scavengers in the management of recurrent attacks of ulcerative colitis: a new approach. J Lab Clin Med 1992;119:710–717.
14.
Salim AS: Allopurinol and dimethyl sulfoxide improve treatment outcomes in smokers with peptic ulcer disease. J Lab Clin Med 1992;119:702–709.
15.
Salim AS: Oxygen-derived free-radical scavengers prolong survival in colonic cancer. Chemotherapy 1992;38:127–134.
16.
Salim AS: Role of oxygen-derived free radical scavengers in the treatment of recurrent pain produced by chronic pancreatitis. A new approach. Arch Surg 1991;126:1109–1114.
17.
Salim AS: Protection against stress-induced acute gastric mucosal injury by free radical scavengers. Intensive Care Med 1991;17:455–460.
18.
Broadwell RD, Salcman M, Kaplan RS: Morphologic effect of dimethyl sulfoxide on the blood-brain barrier. Science 1982;217:164–166.
19.
Ikeda Y, Long DM: Comparative effects of direct and indirect hydroxyl radical scavengers on traumatic brain oedema. Acta Neurochir Suppl (Wien) 1990;51:74–76.
20.
Rosenstein ED: Topical agents in the treatment of rheumatic disorders. Rheum Dis Clin North Am 1999;25:899–918.
21.
Goto I, Yamamoto-Yamagushi Y, Honma Y: Enhancement of sensitivity of human lung adenocarcinoma cells to growth-inhibitory activity of interferon a by differentiation inducing agents. Br J Cancer 1996;74:546–554.
22.
Abdullaeva GK, Shakimova BS: An evaluation of the efficacy of treating rheumatoid arthritis with preparations for local use (in Russian). Revmatologiia (Mosk) 1989;4:35–39.
23.
Murav’ev IV: Treatment of rheumatoid synovitis by intra-articular administration of dimethyl sulfoxide and corticosteroid. Ter Arkh 1986;58:104–105.
24.
Shirley SW, Steward BH, Mirelman S: Dimethyl sulfoxide in treatment of inflammatory genitourinary disorders. Urology 1978;11:215–220.
25.
Swanson BN: Medical use of dimethyl sulfoxide (DMSO). Rev Clin Basic Pharm 1985;5:1–33.
26.
Guerre P, Burgat V, Casali F: Le diméthylsulfoxyde (DMSO) usages experimentaux et toxicité. Rev Med Vet 1999;150:391–412.
27.
Bertelli G, Gozza A, Forno GB, Vidili MG, Silvestro S, Venturini M, Del Mastro L, Garrone O, Rosso R, Dini D: Topical dimethyl sulfoxide for the prevention of soft tissue injury after extravasation of vesicant cytotoxic drugs: a prospective clinical study. J Clin Oncol 1995;13:2851–2855.
28.
Smith RS: A comprehensive macrophage-T-lymphocyte theory of schizophrenia. Med Hypotheses 1992;39:248–257.
29.
Kingery WS: A critical review of controlled clinical trials for peripheral neuropathic pain and complex regional pain syndromes. Pain 1997;73:123–139.
30.
Regelson W, Harkins SW: ‘Amyloid is not a tombstone’ – a summation. The primary role for cerebrovascular and CSF dynamics as factors in Alzheimer’s disease (AD): DMSO, fluorocarbon oxygen carriers, thyroid hormonal, and other suggested therapeutic measures. Ann NY Acad Sci 1997;826:348–374.
31.
Davis JM, Rowley SD, Braine HG, Piantadosi S, Santos GW: Clinical toxicity of cryopreserved bone marrow graft infusion. Blood 1990;75:781–786.
32.
O’Donnell JR, Burnett AK, Sheehan T, Tansey P, McDonald GA: Safety of dimethyl sulphoxide. Lancet 1981;1:498.
33.
Samoszuk M, Reid ME, Toy PT: Intravenous dimethyl sulfoxide therapy causes severe hemolysis mimicking a hemolytic transfusion reaction. Transfusion 1983;23:405.
34.
Stroncek DF, Fautsch SK, Lasky LC, Hurd DD, Ramsay NKC, McCullough J: Adverse reactions in patients transfused with cryopreserved marrow. Transfusion 1991;31:521–526.
35.
Berenson RJ, Bensinger WI, Kalamasz D, Schuening F, Deeg HJ, Storb R: Avidin-biotin immunoadsorption. A technique to purify cells and its potential applications; in Gale RP, Champlin R (eds): Progress in Bone Marrow Transplantation. New York, Liss, 1987, p 423.
36.
Smith DM, Weisenburger DD, Bierman P, Kessinger A, Vaughan WP, Armitage J: Acute renal failure associated with autologous bone marrow transplantation. Bone Marrow Transplant 1987;2:195–201.
37.
Hameroff SR, Otto CW, Kanel J, Weinstein PR, Blitt CD. Acute cardiovascular effects of dimethyl sulfoxide. Ann NY Acad Sci 1983;411:94–99.
38.
Styler MJ, Topolsky DL, Crilley PA, Covalesky V, Bryan R, Bulova S, Brodsky I: Transient high grade heart block following autologous bone marrow infusion. Bone Marrow Transplant 1992;10:435–438.
39.
Shlafer M, Matheny JL, Karow AM Jr: Cardiac chronotropic mechanisms of dimethyl sulfoxide: inhibition of acetylcholinesterase and antagonism of negative chronotropy by atropine. Arch Int Pharmacodyn Ther 1976;221:21–31.
40.
Rapoport AP, Rowe JM, Packman CH, Ginsberg SJ: Cardiac arrest after autologous marrow infusion. Bone Marrow Transplant 1991;7:401–403.
41.
Baum CM, Weissman IL, Tsukamoto AS, Buckle AM, Peault B: Isolation of a candidate human hematopoietic stem cell population. Proc Natl Acad Sci USA 1992;89:2804–2808.
42.
Pegg DE, Kemp NH: Collection, storage, and administration of autologous bone-marrow. Lancet 1960;ii:1426–1429.
43.
Jacob SW, Herschler R: Dimethyl sulfoxide after twenty years. Ann NY Acad Sci 1983;411:xiii–xvii.
44.
Petropoulou AD, Bellochine R, Norol F, Marie JP, Rio B: Coronary artery spasm after infusion of cryopreserved cord blood cells. Bone Marrow Transplant 2007;40:397–398.
45.
Bakken AM: Cryopreserving human peripheral blood progenitor cells. Curr Stem Cell Res Ther 2006;1:47–54.
46.
Abrahamsen JF, Bakken AM, Bruserud Ø: Cryopreserving human peripheral blood progenitor cells with 5-percent rather than 10-percent DMSO results in less apoptosis and necrosis in CD34+ cells. Transfusion 2002;12:1573–1580.
47.
Laroche V, McKenna DH, Moroff G, Schierman T, Kadidlo D, McCullough J: Cell loss and recovery in umbilical cord blood processing: a comparison of postthaw and postwash samples. Transfusion 2005;45:1909–1916.
48.
Meyer TP, Hofmann B, Zaisserer J, Jacobs VR, Fuchs B, Rapp S, Weinauer F, Burkhart J: Analysis and cryopreservation of hematopoietic stem and progenitor cells from umbilical cord blood. Cytotherapy 2006;8:265–276.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.