Scoping review of factors associated with stem cell mobilization and collection in allogeneic stem cell donors.
Peck RC., Knapp-Wilson A., Burley K., Dorée C., Griffin J., Mumford AD., Stanworth S., Sharplin K.
BACKGROUND: There is a large inter-individual variation in the efficacy of CD34+ cell mobilization and collection in healthy allogenic hematopoietic stem cell donors. Donor characteristics, blood cell counts, and factors related to mobilization and collection have previously been associated with blood CD34+ cell count or CD34+ cell yield after G-CSF mobilization and collection. Since the literature reporting associations is heterogeneous, we clarify the determinants of CD34+ count and yield in a scoping review. MATERIALS AND METHODS: Studies published between 2000 and 2023 were evaluated if they reported allogeneic donors undergoing G-CSF mobilization and peripheral blood stem cell collection (PBSC). Eligible studies assessed blood CD34+ cell count or CD34+ cell yield in the first PBSC collection after mobilization with 4 or 5 days of G-CSF treatment. Associations were recorded between these outcomes and donor factors (age, gender, weight, ethnicity), mobilization factors (G-CSF scheduling or dose), collection factors (venous access, processed blood volume) or laboratory factors (blood cell counts at baseline or after mobilization). RESULTS: The 52 studies each evaluated between 15 and 20,884 donors. 43 studies were retrospective, 33 assessed blood CD34+ cell counts and 39 assessed CD34+ cell yield from PBSC. Blood CD34+ cell counts consistently predicted CD34+ cell yield. Younger donors usually had higher blood CD34+ cell counts and CD34+ cell yield. Most studies that investigated the effect of donor ancestry found that non-European ancestry donors had higher blood CD34+ cell counts after mobilization and CD34+ cell yields from collection. CONCLUSIONS: There remains poor consensus about the best predictors of blood CD34+ cell counts and yield that requires further prospective study, particularly of the role of donor ancestry. The current focus on donor gender as a major predictor requires re-evaluation.