Hematopoietic engraftment of dimethyl sulfoxide-depleted autologous peripheral blood progenitor cells.

BACKGROUND: Autologous stem cell transplantation with cryopreserved autografts is a prerequisite for high-dose chemotherapy in treatment of several malignancies. Adverse effects due to the cryoprotectant dimethyl sulfoxide (DMSO) vary from mild to severe. DMSO-associated adverse effects can be reduced by DMSO depletion before autograft infusion. The aim was to investigate whether DMSO depletion by manual single wash reduced frequency of adverse effects or had detrimental effects on the engraftment potential of peripheral blood progenitor cell (PBPC) autografts. STUDY DESIGN AND METHODS: Ten percent DMSO was used to cryopreserve PBPC autografts for a total of 53 patients with multiple myeloma (n = 41), non-Hodgkin's lymphoma (n = 8), amyloidosis (n = 3), and polyneuropathy, organomegaly, endocrinopathy, M protein, and skin changes (POEMS) syndrome (n = 1). After high-dose chemotherapy, 34 patients received unmanipulated autografts, whereas for 19 patients the autografts were manually washed before stem cell infusion. Adverse effects after the infusion as well as neutrophil (neutrophil count >0.5 x 10(9)/L) and platelet (PLT) engraftment (PLT count >20 x 10(9)/L) for these two groups were compared. RESULTS: DMSO depletion reduced the frequency of adverse effects significantly. Patients transplanted with DMSO-depleted autografts had similar neutrophil engraftment time as patients receiving unmanipulated autografts. PLT engraftment time, however, was significantly prolonged and PLT transfusion requirements significantly increased for patients receiving DMSO-depleted autografts, even though the numbers of infused CD34+ cells per kg did not differ between the groups. CONCLUSIONS: DMSO depletion through a manual single wash is a time-consuming procedure that reduces adverse effects. Although the procedure leads to an increase of 2 days in PLT engraftment time, it can be recommended for selected patients with high risk of serious DMSO toxicity.

Autologous peripheral blood progenitor cells cryopreserved with 5 and 10 percent dimethyl sulfoxide alone give comparable hematopoietic reconstitution after transplantation.

BACKGROUND: Previous in vitro studies have demonstrated decreased apoptosis and necrosis in peripheral blood progenitor cells (PBPCs) cryopreserved with 5 percent instead of 10 percent dimethyl sulfoxide (DMSO). This study was carried out to investigate whether these in vitro findings were supported by clinical data concerning hematopoietic engraftment after autologous stem cell transplantations with PBPCs cryopreserved with 5 and 10 percent DMSO. STUDY DESIGN AND METHODS: During a 6-year period, 103 consecutive patients with newly diagnosed multiple myeloma (MM; n = 58) and lymphoma (n = 45) were transplanted with autologous PBPCs. Throughout the first part of the period cells were cryopreserved with 10 percent DMSO and later with 5 percent. A retrospective comparison was carried out of the clinical results for these two groups. RESULTS: No significant difference in median time to neutrophil and platelet (PLT) engraftment was demonstrated for MM and lymphoma patients transplanted with PBPCs cryopreserved with 5 or 10 percent DMSO. Time until neutrophil counts of more than 0.5 x 10(9) per L was 10 days both for the 5 and 10 percent MM groups and 12 days for both the 5 and the 10 percent lymphoma patients. Median time until stable PLT counts of more than 20 x 10(9) per L was 11 days in all four groups. In addition, transfusion requirements and duration of days admitted to hospital did not differ between the groups. CONCLUSION: The routines for cryopreservation of autografts vary considerably between transplantation centers, and this makes it difficult to compare different clinical studies. Our results suggest that cryopreservation with 5 percent DMSO alone followed by storage in nitrogen is a simple, highly standardized, and safe procedure for cryopreservation of autologous stem cell graft.