Cardiovascular changes associated with infusion of hematopoietic cell grafts in oncohematological patients — impact of cryopreservation with dimethylsulfoxide
Aim: Dimethylsulfoxide (DMSO) is the most frequently used agent for hematopoietic cell (HC) graft cryopreservation. This study aimed to monitor blood pressure and heart rate (HR) during HC graft infusion and assess the impact of cryopreservation with DMSO. Methods: 153 HC graft infusions in 153 co...
Gespeichert in:
| Datum: | 2009 |
|---|---|
| Hauptverfasser: | , , , , , |
| Format: | Artikel |
| Sprache: | English |
| Veröffentlicht: |
Інститут експериментальної патології, онкології і радіобіології ім. Р.Є. Кавецького НАН України
2009
|
| Schriftenreihe: | Experimental Oncology |
| Schlagworte: | |
| Online Zugang: | http://dspace.nbuv.gov.ua/handle/123456789/135722 |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| Назва журналу: | Digital Library of Periodicals of National Academy of Sciences of Ukraine |
| Zitieren: | Cardiovascular changes associated with infusion of hematopoietic cell grafts in oncohematological patients — impact of cryopreservation with dimethylsulfoxide / J.M. Horacek, L. Jebavy, M. Jakl, P. Zak, P. Mericka, J. Maly // Experimental Oncology. — 2009. — Т. 31, № 2. — С. 121–122. — Бібліогр.: 15 назв. — англ. |
Institution
Digital Library of Periodicals of National Academy of Sciences of Ukraine| id |
irk-123456789-135722 |
|---|---|
| record_format |
dspace |
| spelling |
irk-123456789-1357222018-06-16T03:11:09Z Cardiovascular changes associated with infusion of hematopoietic cell grafts in oncohematological patients — impact of cryopreservation with dimethylsulfoxide Horacek, J.M. Jebavy, L. Jakl, M. Zak, P. Mericka, P. Maly, J. Short communications Aim: Dimethylsulfoxide (DMSO) is the most frequently used agent for hematopoietic cell (HC) graft cryopreservation. This study aimed to monitor blood pressure and heart rate (HR) during HC graft infusion and assess the impact of cryopreservation with DMSO. Methods: 153 HC graft infusions in 153 consecutive hematological patients (mean age 49.1 ± 12.6 years; 80 males) were evaluated. Cryopreservation with DMSO was used in 133 grafts (DMSO group). Twenty grafts were infused directly without cryopreservation (control group). Systolic blood pressure (SBP), diastolic blood pressure (DBP) and HR were measured immediately before and after HC graft infusion. Results: SBP and DBP increased significantly after graft infusions cryopreserved with DMSO (p < 0.0001 for SBP; p < 0.01 for DBP). Increases (> 10 mmHg) in SBP were seen in 42 (31.6%) patients; in DBP in 31 (23.3%) patients. Changes in HR were non-significant in DMSO group. Increases in BP and HR correlated with increasing DMSO dose (p < 0.01; p < 0.05, respectively). Changes in SBP, DBP and HR were non-significant in control group. Conclusion: HC graft infusions cryopreserved with DMSO could cause statistically significant increases in SBP and DBP, without changes in HR. These changes were mostly transient and asymptomatic, not requiring therapeutic intervention. However, they might cause complications, especially in patients with preexisting cardiovascular disease, who should be monitored closely during HC transplantation. 2009 Article Cardiovascular changes associated with infusion of hematopoietic cell grafts in oncohematological patients — impact of cryopreservation with dimethylsulfoxide / J.M. Horacek, L. Jebavy, M. Jakl, P. Zak, P. Mericka, J. Maly // Experimental Oncology. — 2009. — Т. 31, № 2. — С. 121–122. — Бібліогр.: 15 назв. — англ. 1812-9269 http://dspace.nbuv.gov.ua/handle/123456789/135722 en Experimental Oncology Інститут експериментальної патології, онкології і радіобіології ім. Р.Є. Кавецького НАН України |
| institution |
Digital Library of Periodicals of National Academy of Sciences of Ukraine |
| collection |
DSpace DC |
| language |
English |
| topic |
Short communications Short communications |
| spellingShingle |
Short communications Short communications Horacek, J.M. Jebavy, L. Jakl, M. Zak, P. Mericka, P. Maly, J. Cardiovascular changes associated with infusion of hematopoietic cell grafts in oncohematological patients — impact of cryopreservation with dimethylsulfoxide Experimental Oncology |
| description |
Aim: Dimethylsulfoxide (DMSO) is the most frequently used agent for hematopoietic cell (HC) graft cryopreservation. This study
aimed to monitor blood pressure and heart rate (HR) during HC graft infusion and assess the impact of cryopreservation with
DMSO. Methods: 153 HC graft infusions in 153 consecutive hematological patients (mean age 49.1 ± 12.6 years; 80 males) were
evaluated. Cryopreservation with DMSO was used in 133 grafts (DMSO group). Twenty grafts were infused directly without cryopreservation
(control group). Systolic blood pressure (SBP), diastolic blood pressure (DBP) and HR were measured immediately
before and after HC graft infusion. Results: SBP and DBP increased significantly after graft infusions cryopreserved with DMSO
(p < 0.0001 for SBP; p < 0.01 for DBP). Increases (> 10 mmHg) in SBP were seen in 42 (31.6%) patients; in DBP in 31 (23.3%)
patients. Changes in HR were non-significant in DMSO group. Increases in BP and HR correlated with increasing DMSO dose
(p < 0.01; p < 0.05, respectively). Changes in SBP, DBP and HR were non-significant in control group. Conclusion: HC graft
infusions cryopreserved with DMSO could cause statistically significant increases in SBP and DBP, without changes in HR. These
changes were mostly transient and asymptomatic, not requiring therapeutic intervention. However, they might cause complications,
especially in patients with preexisting cardiovascular disease, who should be monitored closely during HC transplantation. |
| format |
Article |
| author |
Horacek, J.M. Jebavy, L. Jakl, M. Zak, P. Mericka, P. Maly, J. |
| author_facet |
Horacek, J.M. Jebavy, L. Jakl, M. Zak, P. Mericka, P. Maly, J. |
| author_sort |
Horacek, J.M. |
| title |
Cardiovascular changes associated with infusion of hematopoietic cell grafts in oncohematological patients — impact of cryopreservation with dimethylsulfoxide |
| title_short |
Cardiovascular changes associated with infusion of hematopoietic cell grafts in oncohematological patients — impact of cryopreservation with dimethylsulfoxide |
| title_full |
Cardiovascular changes associated with infusion of hematopoietic cell grafts in oncohematological patients — impact of cryopreservation with dimethylsulfoxide |
| title_fullStr |
Cardiovascular changes associated with infusion of hematopoietic cell grafts in oncohematological patients — impact of cryopreservation with dimethylsulfoxide |
| title_full_unstemmed |
Cardiovascular changes associated with infusion of hematopoietic cell grafts in oncohematological patients — impact of cryopreservation with dimethylsulfoxide |
| title_sort |
cardiovascular changes associated with infusion of hematopoietic cell grafts in oncohematological patients — impact of cryopreservation with dimethylsulfoxide |
| publisher |
Інститут експериментальної патології, онкології і радіобіології ім. Р.Є. Кавецького НАН України |
| publishDate |
2009 |
| topic_facet |
Short communications |
| url |
http://dspace.nbuv.gov.ua/handle/123456789/135722 |
| citation_txt |
Cardiovascular changes associated with infusion of hematopoietic cell grafts in oncohematological patients — impact of cryopreservation with dimethylsulfoxide / J.M. Horacek, L. Jebavy, M. Jakl, P. Zak, P. Mericka, J. Maly // Experimental Oncology. — 2009. — Т. 31, № 2. — С. 121–122. — Бібліогр.: 15 назв. — англ. |
| series |
Experimental Oncology |
| work_keys_str_mv |
AT horacekjm cardiovascularchangesassociatedwithinfusionofhematopoieticcellgraftsinoncohematologicalpatientsimpactofcryopreservationwithdimethylsulfoxide AT jebavyl cardiovascularchangesassociatedwithinfusionofhematopoieticcellgraftsinoncohematologicalpatientsimpactofcryopreservationwithdimethylsulfoxide AT jaklm cardiovascularchangesassociatedwithinfusionofhematopoieticcellgraftsinoncohematologicalpatientsimpactofcryopreservationwithdimethylsulfoxide AT zakp cardiovascularchangesassociatedwithinfusionofhematopoieticcellgraftsinoncohematologicalpatientsimpactofcryopreservationwithdimethylsulfoxide AT merickap cardiovascularchangesassociatedwithinfusionofhematopoieticcellgraftsinoncohematologicalpatientsimpactofcryopreservationwithdimethylsulfoxide AT malyj cardiovascularchangesassociatedwithinfusionofhematopoieticcellgraftsinoncohematologicalpatientsimpactofcryopreservationwithdimethylsulfoxide |
| first_indexed |
2025-07-09T23:58:52Z |
| last_indexed |
2025-07-09T23:58:52Z |
| _version_ |
1837215816874983424 |
| fulltext |
Experimental Oncology 31, 121–122, 2009 (June) 121
Dimethylsulfoxide (DMSO) is a chemical com-
pound with a formula (CH3)2SO. DMSO has been
used as a solvent in biological studies and as a vehicle
for drug therapy for a long time [1, 2]. Since 1990,
DMSO has been the most frequently used substance
for cryopreservation of hematopoietic cell (HC) grafts
[3–5]. The cryopreservation solution usually contains
10% DMSO and 2–4% albumin or autologous plasma.
The grade of toxicity experienced by patients when
cryopreserved HC grafts are infused is related to the
amount of DMSO present in the HC concentrates.
Recently, some institutions have started using 5%
DMSO as cryoprotectant for the autologous HC grafts
[6, 7]. The maximum recommended daily dose of
DMSO is 1 g/kg of the recipient body weight due to
dose-dependent side effects. The most common side
effects of DMSO include nausea, vomiting, diarrhea,
rashes, bronchospasm, headache and cardiovascular
changes [8–10]. DMSO may lead to changes in blood
pressure (BP) and heart rate (HR). In most studies,
increase in BP and decrease in HR were found [2, 11,
12]. However, decrease in BP or increase in HR or no
changes in BP and HR were reported in several stu-
dies and the results are inconsistent [9, 13]. Thus, the
European Group for Blood and Marrow Transplantation
(EBMT) has recently launched a multicenter study on
monitoring of side effect of DMSO including cardiovas-
cular changes (so called “DMSO Toxicity Study”). The
results of the study have not been published yet.
The aim of our study was to monitor BP and HR du-
ring HC graft infusions and to assess the effect of DMSO
cryopreservation on these parameters in patients trans-
planted for a hematological disease in our transplant
center (Department of Medicine II, Clinical Hematology,
University Hospital Hradec Kralove, Czech Republic).
We evaluated 153 HC graft infusions in 153 con-
secutive hematological patients. The patients con-
sisted of 80 males and 73 females with the mean age
of 49.1 ± 12.6 years. Forty-two patients were treated
for arterial hypertension and were well compensated
before HC transplantation. Cryopreservation with
DMSO was used in 133 (86.9%) grafts, 20 (13.1%)
grafts were infused directly without cryopreservation
(control group). One hundred and fifteen (75.2%)
grafts were autologous and 38 (24.8%) allogeneic
(from that 18 matched unrelated donor transplants).
The most frequent diagnoses were multiple myeloma
(55 patients), non-Hodgkin’s lymphoma (35 patients)
and acute myeloid leukemia (29 patients).
Systolic blood pressure (SBP), diastolic blood pres-
sure (DBP) and heart rate (HR) were measured imme-
diately before and after HC graft infusion. Changes (ei-
ther increase or decrease) in SBP or DBP by more than
CARDIOVASCULAR CHANGES ASSOCIATED WITH INFUSION
OF HEMATOPOIETIC CELL GRAFTS IN ONCOHEMATOLOGICAL
PATIENTS — IMPACT OF CRYOPRESERVATION WITH
DIMETHYLSULFOXIDE
J.M. Horacek1, 2, *, L. Jebavy1, 2, M. Jakl2, P. Zak1, P. Mericka3, J. Maly1
1Department of Medicine II — Clinical Hematology, Faculty of Medicine, University Hospital and Charles
University, Hradec Kralove 500 05, Czech Republic
2Department of Internal Medicine, Faculty of Military Health Sciences, University of Defence, Hradec
Kralove 500 01, Czech Republic
3Tissue Bank, Faculty of Medicine, University Hospital and Charles University, Hradec Kralove 500 05,
Czech Republic
Aim: Dimethylsulfoxide (DMSO) is the most frequently used agent for hematopoietic cell (HC) graft cryopreservation. This study
aimed to monitor blood pressure and heart rate (HR) during HC graft infusion and assess the impact of cryopreservation with
DMSO. Methods: 153 HC graft infusions in 153 consecutive hematological patients (mean age 49.1 ± 12.6 years; 80 males) were
evaluated. Cryopreservation with DMSO was used in 133 grafts (DMSO group). Twenty grafts were infused directly without cryo-
preservation (control group). Systolic blood pressure (SBP), diastolic blood pressure (DBP) and HR were measured immediately
before and after HC graft infusion. Results: SBP and DBP increased significantly after graft infusions cryopreserved with DMSO
(p < 0.0001 for SBP; p < 0.01 for DBP). Increases (> 10 mmHg) in SBP were seen in 42 (31.6%) patients; in DBP in 31 (23.3%)
patients. Changes in HR were non-significant in DMSO group. Increases in BP and HR correlated with increasing DMSO dose
(p < 0.01; p < 0.05, respectively). Changes in SBP, DBP and HR were non-significant in control group. Conclusion: HC graft
infusions cryopreserved with DMSO could cause statistically significant increases in SBP and DBP, without changes in HR. These
changes were mostly transient and asymptomatic, not requiring therapeutic intervention. However, they might cause complications,
especially in patients with preexisting cardiovascular disease, who should be monitored closely during HC transplantation.
Key Words: dimethylsulfoxide, cryopreservation, transplantation, blood pressure, heart rate.
Received: May 5, 2009.
*Correspondence: E-mail: jan.hor@post.cz
Abbreviations used: BP – blood pressure, DBP – diastolic blood
pressure, DMSO – dimethylsulfoxide, HC – hematopoietic cell(s),
SBP – systolic blood pressure, HR – heart rate.
Exp Oncol 2009
31, 2, 121–122
122 Experimental Oncology 31, 121–122, 2009 (June)
10 mmHg or changes in HR by more than 10 beats/min
were considered significant in our study.
Statistical analysis was performed with the “Sta-
tistica for Windows, Version 5.0” program. Paired two
tailed t-tests and McNemar tests were used. The va-
lues are expressed as mean ± standard deviation (SD).
Probability values p < 0.05 and lower were considered
statistically significant.
The results are shown in Table 1 and Table 2. SBP
and DBP increased significantly just after graft infu-
sions cryopreserved with DMSO. Increase in SBP by
more than 10 mmHg was seen in 42 (31.6%) patients,
in DBP in 31 (23.3%) patients. Moreover, the increase
in BP and HR correlated with the increasing DMSO
dose — changes were more pronounced in patients
with the total DMSO dose above 0.8 g/kg of recipient
body weight (p < 0.01, p < 0.05 respectively). In the
control group without DMSO cryopreservation, the
changes in SBP, DBP and HR were not significant.
Changes in SBP, DBP and HR were not significantly
different in patients treated for arterial hypertension
in comparison with the other patients.
Table 1. Changes in blood pressure and heart rate during hematopoietic
cell graft infusion with dimethylsulfoxide (n = 133)
Parameters Before HCT After HCT p
SBP (mmHg) 122.3 ± 17.9 127.7 ± 18.1 < 0.0001
DBP (mmHg) 70.9 ± 12.3 74.1 ± 12.6 < 0.01
HR (/min) 81.5 ± 13.6 81.8 ± 14.2 NS
In Table 1 and Table 2: HCT – hematopoietic cell transplantation.
Table 2. Changes in blood pressure and heart rate during hematopoietic
cell graft infusion without dimethylsulfoxide (n = 20)
Parameters Before HCT After HCT p
SBP (mmHg) 136.3 ± 17.6 138.4 ± 15.6 NS
DBP (mmHg) 78.1 ± 9.5 76.9 ± 11.3 NS
HR (/min) 81.6 ± 23.0 81.1 ± 21.8 NS
Our results on 153 consecutive hematological pa-
tients show that only HC graft infusions cryopreserved
with DMSO caused statistically significant increases
in SBP and DBP. In our study, significant increases
(by more than 10 mmHg) in SBP were found in 31.6%
patients, in DBP in 23.3% patients. Changes in HR
were not statistically significant. These changes were
mostly transient and asymptomatic and did not require
therapeutic intervention. However, they might cause
complications, especially in patients with preexisting
cardiovascular disease (amyloidosis with cardiac in-
volvement, chemotherapy-induced cardiomyopathy,
coronary artery disease, cardiac arrhythmia, not
adequately compensated arterial hypertension prior
to HC transplantation, etc.). The patients at risk for
cardiovascular complications should be monitored
closely during cryopreserved HC graft infusion, e.g.
continuous monitoring of ECG and BP.
To reduce the side effects of cryopreservation
agent DMSO, the amount of infused DMSO could be
decreased by centrifugation right before the HC graft
infusion [14]. The drawback of this procedure is a sig-
nificant loss of HC (according to our experience up to
30%) which may result in delayed engraftment. Ano-
ther possibility is to fractionate the application of HC
graft in more consecutive days and thereby reduce the
total daily DMSO dose and toxicity [15].
To conclude, HC graft infusions cryopreserved with
DMSO could cause statistically significant increases
in SBP and DBP, without changes in HR. Patients with
preexisting cardiovascular disease should by moni-
tored closely during HC transplantation. Alternatively,
the amount of DMSO could be depleted before HC
graft infusions.
ACKNOWLEDGMENTS
The work was supported by research projects MO
0FVZ 0000503 (Czech Ministry of Defence) and MZO
00179906 (Czech Ministry of Health).
REFERENCES
David NA. 1. The pharmacology of dimethyl sulfoxide.
Annu Rev Pharmacol 1972; 12: 353–74.
Santos NC, Figueira-Coelho J, Martins-Silva J, Sal-2.
danha C. Multidisciplinary utilization of dimethyl sulfoxide:
pharmacological, cellular, and molecular aspects. Biochem
Pharmacol 2003; 65: 1035–41.
Rowley SD. 3. Hematopoietic stem cell cryopreserva-
tion: a review of current techniques. J Hematother 1992; 1:
233–50.
Berz D, McCormack EM, Winer ES, 4. et al. Cryopreser-
vation of hematopoietic stem cells. Am J Hematol 2007; 82:
463–72.
Watt SM, Austin E, Armitage S. 5. Cryopreservation
of hematopoietic stem/progenitor cells for therapeutic use.
Methods Mol Biol 2007; 368: 237–59.
Liseth K, Abrahamsen JF, Bjørsvik S, 6. et al. The viability
of cryopreserved PBPC depends on the DMSO concentration
and the concentration of nucleated cells in the graft. Cyto-
therapy 2005; 7: 328–33.
Bakken AM. 7. Cryopreserving human peripheral blood
progenitor cells. Curr Stem Cell Res Ther 2006; 1: 47–54.
Stroncek DF, Fautsch SK, Lasky LC, 8. et al. Adverse
reactions in patients transfused with cryopreserved marrow.
Transfusion 1991; 31: 521–6.
Zambelli A, Poggi G, Da Prada G, 9. et al. Clinical toxicity
of cryopreserved circulating progenitor cells infusion. Antican-
cer Res 1998; 18: 4705–8.
Donmez A, Tombuloglu M, Gungor A, 10. et al. Clinical
side effects during peripheral blood progenitor cell infusion.
Transfus Apher Sci 2007; 36: 95–101.
Davis JM, Rowley SD, Braine HG, 11. et al. Clinical
toxicity of cryopreserved bone marrow graft infusion. Blood
1990; 75: 781–6.
Keung YK, Lau S, Elkayam U, 12. et al. Cardiac arrhyth-
mia after infusion of cryopreserved stem cells. Bone Marrow
Transplant 1994; 14: 363–7.
López-Jiménez J, Cerveró C, Muñoz A, 13. et al. Car-
diovascular toxicities related to the infusion of cryopreserved
grafts: results of a controlled study. Bone Marrow Transplant
1994; 13: 789–93.
Syme R, Bewick M, Stewart D, 14. et al. The role of deple-
tion of dimethyl sulfoxide before autografting: on hematologic
recovery, side effects, and toxicity. Biol Blood Marrow Trans-
plant 2004; 10: 135–41.
Martino M, Morabito F, Messina G, 15. et al. Frac-
tionated infusions of cryopreserved stem cells may prevent
DMSO-induced major cardiac complications in graft reci-
pients. Haematologica 1996; 81: 59–61.
Copyright © Experimental Oncology, 2009
|