![]() ![]() He was alert with a normal speech but disoriented to time and place. ![]() Subsequently, the patient appeared confused and kept reiterating the same questions over and over again. The patient was provided with a tight paper bag to breathe in and received 2 mg of intravenous midazolam for sedation. Arterial blood gases were taken and showed severe respiratory alkalosis with PH of 7.59, PaO 2 of 207 and PaCO 2 of 22. Two ampules of calcium gluconate were infused in 100 mL normal saline over 15 minutes. At this point, the patient reported blurring of vision, became agitated and hyperventilating with a respiratory rate reaching 33/min. Five minutes later he complained of numbness and stiffness of his right upper extremity that gradually worsened. ![]() Five minutes following the start of the infusion, the patient reported headache followed by chest tightness. The patient was transfused with 200 mL of stem cells (CD34 cell count = 7.55x10/kg) over 15 minutes. The patient received 8 mg dexamethasone intravenously 30 minutes prior to the infusion. The infusion of APBSC was administered according to a predefined protocol. Salvage chemotherapy included high dose BEAM (carmustine, etoposide, cytarabin, melphalan) during which the patient had no complications. The patient’s pre-transplant evaluation was satisfactory. The cells were preserved in 10% DMSO/30% Plasmalyte A/22.5% autologous irradiated plasma and stored in liquid nitrogen. APBSC were collected, and the cell count was performed by flow cytometry. He received 3 cycles of ICE chemotherapy (ifosfamide, carboplatin, and etoposide) followed by stem cell collection and cryopreservation.ĪPBSC were prepared in the department of laboratory medicine following a standardized protocol. The patient was treated with 6 cycles of ABVD chemotherapy (doxorubicin, bleomycin, vinblastine, and dacarbazine) with complete remission in November 2006. Pathological diagnosis was Hodgkin’s lymphoma. His history dates back to May 2006 when he presented with cervical, axillary and mediastinal lymphadenopathy associated with fever, chills, night sweats and weight loss. 1– 4 We report the first MRI documented case of transient global amnesia (TGA) that occurred in the setting of DMSO-cryopreserved APBSC infusion for a relapsing lymphoma.Ī 30-year-old man, diagnosed with Hodgkin’s lymphoma, was admitted to our medical center for autologous peripheral blood stem cell transplantation. Side effects upon infusion of DMSO-cryopreserved APBSC mainly consist of nausea, emesis, chills, rigors, and cardiovascular events, such as bradyarrhythmia or hypotension. This observation underlines the need for an adequate DMSO depletion to limit neurotoxicity or other adverse manifestations.ĭimethylsulfoxide (DMSO) is a solvent commonly used for the cryopreservation of autologous peripheral blood stem cells (APBSC). The clinical course during the reaction is described and an explanation of the possible causes is discussed. The patient developed a rare reaction during the infusion manifesting as transient global amnesia. We report the case of a patient who received DMSO-cryopreserved APBSC after myeloablative chemotherapy for a relapsing lymphoma. Dimethylsulfoxide (DMSO) is a solvent commonly used for the cryopreservation of autologous peripheral blood stem cells (APBSC). ![]()
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