Variation in hydration use after reinfusion of autologous stem cells in dimethyl sulfoxide (DMSO): a survey of EBMT centers

Abstract Dimethyl sulfoxide (DMSO) is commonly used in hematopoietic stem cell (HSC) cryopreservation with various strategies employed to reduce DMSO related toxicity. A survey was conducted among EBMT centers to investigate the use of hydration following reinfusion of autologous HSCs in DMSO. Sixty-four questionnaires from 64 centers were analyzed. Fifty-four centers (84.3 %) gave hydration post-reinfusion of autologous HSC’s. Eighteen centers (28.1%) gave hydration depending on patient characteristics or the regimen of chemotherapy chosen. Two centers (3.1%) gave hydration only when there was insufficient oral intake. Ten centers (15.6%) stated they never gave post-reinfusion hydration. The most frequently reported reason to start post-reinfusion hydration was ‘to protect the kidneys from DMSO’ and ‘to flush out DMSO’ (84.3%). In 62.8% of responses, multiple reasons for hydration were cited, not only related to DMSO. No consensus in hydration fluid or volume was observed. Evidence is lacking to suggest hydration post-reinfusion reduces the toxicity of DMSO. Further research is necessary to explore the use of hydration post-reinfusion of stem cells. Existing knowledge surrounding use of lower concentrations of DMSO to reduce toxicity of DMSO for patients receiving an autologous stem cell transplantation, could be explored.