Dimethyl sulfoxide in cryopreserved mesenchymal stromal cell therapy products: is there a safety risk to patients?

Abstract Dimethyl sulfoxide (DMSO) is the preferred cryoprotectant for the cryopreservation of mesenchymal stromal cells (MSCs). As DMSO has been associated with in-vivo toxicity, its potential side effects when administered with MSC therapies are a matter of debate. To contribute to the assessment...

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Main Authors: Elke Niebergall-Roth, Mark Andreas Kluth
Format: Article
Language:English
Published: BMC 2025-08-01
Series:Journal of Translational Medicine
Subjects:
Online Access:https://doi.org/10.1186/s12967-025-06807-6
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author Elke Niebergall-Roth
Mark Andreas Kluth
author_facet Elke Niebergall-Roth
Mark Andreas Kluth
author_sort Elke Niebergall-Roth
collection DOAJ
description Abstract Dimethyl sulfoxide (DMSO) is the preferred cryoprotectant for the cryopreservation of mesenchymal stromal cells (MSCs). As DMSO has been associated with in-vivo toxicity, its potential side effects when administered with MSC therapies are a matter of debate. To contribute to the assessment of the potential patient safety risk that may be posed by typical amounts of DMSO delivered with cryopreserved MSC-based therapy products, published safety data from intravenous and topical applications of DMSO and DMSO-containing MSC products in humans were reviewed. For the intravenous route, 1173 patients treated with 1–24 DMSO-containing MSC infusions were analyzed. For the topical route, for which data from the administration of DMSO-containing MSC products are lacking, the risk of local toxicity was estimated on the basis of the available information from the topical use of DMSO for wound healing purposes, whereas the risk of systemic toxicity was estimated on the basis of a worst-case scenario assuming 100% transdermal absorption. The doses of DMSO delivered via intravenous administration of MSC products were 2.5–30 times lower than the dose of 1 g DMSO/kg typically accepted for hematopoietic stem cell transplantation, and with adequate premedication, only isolated infusion-related reactions, if any, were reported. Published experience with the application of DMSO to skin wounds suggests that DMSO concentrations applied with undiluted DMSO-cryopreserved MSC products are unlikely to cause significant local adverse effects. In the worst-case scenario, assuming complete systemic absorption of DMSO from an MSC product applied to a large wound in a lightweight patient, the systemic exposure to DMSO would be approximately 55 times lower than that from an intravenous dose of 1 g/kg. In conclusion, the available data do not indicate significant safety concerns with the DMSO contained in intravenous or topical MSC products cryopreserved according to current standard protocols.
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spelling doaj-art-b7972624eec54c61ba893b67c678096c2025-08-24T11:47:56ZengBMCJournal of Translational Medicine1479-58762025-08-0123112010.1186/s12967-025-06807-6Dimethyl sulfoxide in cryopreserved mesenchymal stromal cell therapy products: is there a safety risk to patients?Elke Niebergall-Roth0Mark Andreas Kluth1RHEACELL GmbH & Co. KGRHEACELL GmbH & Co. KGAbstract Dimethyl sulfoxide (DMSO) is the preferred cryoprotectant for the cryopreservation of mesenchymal stromal cells (MSCs). As DMSO has been associated with in-vivo toxicity, its potential side effects when administered with MSC therapies are a matter of debate. To contribute to the assessment of the potential patient safety risk that may be posed by typical amounts of DMSO delivered with cryopreserved MSC-based therapy products, published safety data from intravenous and topical applications of DMSO and DMSO-containing MSC products in humans were reviewed. For the intravenous route, 1173 patients treated with 1–24 DMSO-containing MSC infusions were analyzed. For the topical route, for which data from the administration of DMSO-containing MSC products are lacking, the risk of local toxicity was estimated on the basis of the available information from the topical use of DMSO for wound healing purposes, whereas the risk of systemic toxicity was estimated on the basis of a worst-case scenario assuming 100% transdermal absorption. The doses of DMSO delivered via intravenous administration of MSC products were 2.5–30 times lower than the dose of 1 g DMSO/kg typically accepted for hematopoietic stem cell transplantation, and with adequate premedication, only isolated infusion-related reactions, if any, were reported. Published experience with the application of DMSO to skin wounds suggests that DMSO concentrations applied with undiluted DMSO-cryopreserved MSC products are unlikely to cause significant local adverse effects. In the worst-case scenario, assuming complete systemic absorption of DMSO from an MSC product applied to a large wound in a lightweight patient, the systemic exposure to DMSO would be approximately 55 times lower than that from an intravenous dose of 1 g/kg. In conclusion, the available data do not indicate significant safety concerns with the DMSO contained in intravenous or topical MSC products cryopreserved according to current standard protocols.https://doi.org/10.1186/s12967-025-06807-6CryopreservationDimethyl sulfoxideMesenchymal stromal cellsToxicitySafety
spellingShingle Elke Niebergall-Roth
Mark Andreas Kluth
Dimethyl sulfoxide in cryopreserved mesenchymal stromal cell therapy products: is there a safety risk to patients?
Journal of Translational Medicine
Cryopreservation
Dimethyl sulfoxide
Mesenchymal stromal cells
Toxicity
Safety
title Dimethyl sulfoxide in cryopreserved mesenchymal stromal cell therapy products: is there a safety risk to patients?
title_full Dimethyl sulfoxide in cryopreserved mesenchymal stromal cell therapy products: is there a safety risk to patients?
title_fullStr Dimethyl sulfoxide in cryopreserved mesenchymal stromal cell therapy products: is there a safety risk to patients?
title_full_unstemmed Dimethyl sulfoxide in cryopreserved mesenchymal stromal cell therapy products: is there a safety risk to patients?
title_short Dimethyl sulfoxide in cryopreserved mesenchymal stromal cell therapy products: is there a safety risk to patients?
title_sort dimethyl sulfoxide in cryopreserved mesenchymal stromal cell therapy products is there a safety risk to patients
topic Cryopreservation
Dimethyl sulfoxide
Mesenchymal stromal cells
Toxicity
Safety
url https://doi.org/10.1186/s12967-025-06807-6
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