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

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 non-washed 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 non-washed 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.