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Peer-reviewedCC BY-NC-NDCardiovascular toxicology

Impact of Dimethyl Sulfoxide on Early Cardiotoxicity After Allogeneic Hematopoietic Stem Cell Transplantation.

  • V Lábska1
  • B Mladosievičová2
  • J Dúbrava3
  • B Žiaková1
  • K Nemergutová1
  • L Sopko1
  • J Lukáš1
  • Ľ Harvanová4,5
5 affiliations
  1. 1Department of Hematology and Transfusiology, Faculty of Medicine, Comenius University, University Hospital Bratislava, Bratislava, Slovakia.
  2. 2Department of Pathological Physiology, Faculty of Medicine, Comenius University, Bratislava, Slovakia.
  3. 3Department of Non-Invasive Cardiology, University Hospital Bratislava, Bratislava, Slovakia.
  4. 4Department of Hematology and Transfusiology, Faculty of Medicine, Comenius University, University Hospital Bratislava, Bratislava, Slovakia. [email protected].
  5. 5Department of Hematology and Transfusion Medicine, Faculty of Medicine, Slovak Medical University, University Hospital, Antolska 11, Bratislava, 85107, Slovakia. [email protected].
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Abstract

During the COVID-19 pandemic, the use of cryopreserved grafts in allogeneic hematopoietic stem cell transplantation (HSCT) increased substantially. Dimethyl sulfoxide (DMSO), used as a cryoprotective agent, is well recognized for its infusion-related toxicity; however, its impact on cardiac function remains unclear.Methods

This prospective study included 96 consecutive patients (median age 46 years) undergoing allogeneic HSCT. Patients were divided according to graft type into cryopreserved (n = 59, 61.5%) and non-cryopreserved (n = 37, 38.5%) groups. Comprehensive echocardiographic assessment was performed before and after transplantation.Results

Significant changes were observed in diastolic parameters (E/A, and E/E'), structural parameters (left ventricular mass and left ventricular mass index), global longitudinal strain (GLS), and right ventricular ejection fraction following HSCT. In the cryopreserved group, E/A ratio decreased below the normal range and E/E' ratio increased significantly, whereas no such changes were observed in the non-cryopreserved group. During the 30-day follow-up period, symptomatic cardiovascular toxicity occurred in 5 patients (5.2%), while subclinical cancer therapy-related cardiac dysfunction was detected in 16 patients (16.7%). Receiver operating characteristic (ROC) analysis demonstrated that GLS predicted cardiotoxicity with an area under the curve (AUC) of 0.88 (95% CI, 0.79-0.98; p < 0.0001). At a cut-off value of - 16.8%, sensitivity was 100% and specificity was 79%.Conclusion

Cryopreserved graft administration may be associated with early alterations in left ventricular diastolic function, potentially reflecting DMSO-related cardiotoxicity. GLS appears to be a sensitive marker for the early detection and prediction of cardiotoxicity in patients undergoing allogeneic HSCT.

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Cite

BibTeXRIS
BibTeX
@article{labska2026impact,
  title = {{Impact of Dimethyl Sulfoxide on Early Cardiotoxicity After Allogeneic Hematopoietic Stem Cell Transplantation.}},
  author = {V Lábska and B Mladosievičová and J Dúbrava and B Žiaková and K Nemergutová and L Sopko and J Lukáš and Ľ Harvanová},
  journal = {Cardiovascular toxicology},
  year = {2026},
  month = oct,
  doi = {10.1007/s12012-026-10207-7},
  url = {https://europepmc.org/article/MED/42875553},
  note = {CC BY-NC-ND},
}
RIS
TY  - JOUR
TI  - Impact of Dimethyl Sulfoxide on Early Cardiotoxicity After Allogeneic Hematopoietic Stem Cell Transplantation.
AU  - V Lábska
AU  - B Mladosievičová
AU  - J Dúbrava
AU  - B Žiaková
AU  - K Nemergutová
AU  - L Sopko
AU  - J Lukáš
AU  - Ľ Harvanová
PY  - 2026
DA  - 2026/10/15
JO  - Cardiovascular toxicology
DO  - 10.1007/s12012-026-10207-7
UR  - https://europepmc.org/article/MED/42875553
AB  - During the COVID-19 pandemic, the use of cryopreserved grafts in allogeneic hematopoietic stem cell transplantation (HSCT) increased substantially. Dimethyl sulfoxide (DMSO), used as a cryoprotective agent, is well recognized for its infusion-related toxicity; however, its impact on cardiac function remains unclear.Methods  This prospective study included 96 consecutive patients (median age 46 years) undergoing allogeneic HSCT. Patients were divided according to graft type into cryopreserved (n = 59, 61.5%) and non-cryopreserved (n = 37, 38.5%) groups. Comprehensive echocardiographic assessment was performed before and after transplantation.Results  Significant changes were observed in diastolic parameters (E/A, and E/E'), structural parameters (left ventricular mass and left ventricular mass index), global longitudinal strain (GLS), and right ventricular ejection fraction following HSCT. In the cryopreserved group, E/A ratio decreased below the normal range and E/E' ratio increased significantly, whereas no such changes were observed in the non-cryopreserved group. During the 30-day follow-up period, symptomatic cardiovascular toxicity occurred in 5 patients (5.2%), while subclinical cancer therapy-related cardiac dysfunction was detected in 16 patients (16.7%). Receiver operating characteristic (ROC) analysis demonstrated that GLS predicted cardiotoxicity with an area under the curve (AUC) of 0.88 (95% CI, 0.79-0.98; p < 0.0001). At a cut-off value of - 16.8%, sensitivity was 100% and specificity was 79%.Conclusion  Cryopreserved graft administration may be associated with early alterations in left ventricular diastolic function, potentially reflecting DMSO-related cardiotoxicity. GLS appears to be a sensitive marker for the early detection and prediction of cardiotoxicity in patients undergoing allogeneic HSCT.
SN  - 1530-7905
SN  - 1559-0259
ER  -