Scoping review of factors associated with stem cell mobilisation and collection in allogeneic stem cell donors

Rachel Peck, Amber Knapp-Wilson, Kate Burley, Carolyn Doree, James Griffin, Andrew Mumford, Simon Stanworth, Kirsty Sharplin
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Abstract

Background: There is a large inter-individual variation in CD34+ cell yield after G-CSF mobilisation and collection from peripheral blood in healthy allogenic haematopoietic stem cell donors. Donor characteristics including gender and age, baseline and precollection blood results, mobilisation factors and collection factors have been associated with CD34+ cell concentration in the blood after G-CSF mobilisation and/or CD34+ cell yield after collection. Since the literature reporting these associations is heterogeneous, we here clarify the determinants of CD34+ cell concentration and yield through a scoping literature review. Materials and Methods: MEDLINE, Embase, PubMed and Stem Cell Evidence were searched for studies published between 2000 and 2023. The inclusion criteria were studies of allogeneic donors undergoing G-CSF mobilisation and peripheral blood stem cell collection (PBSC). Eligible studies assessed an outcome of mobilisation or collection efficacy, indicated by the blood CD34+ cell concentration after 4 or 5 days of G-CSF treatment and/or CD34+ cell yield in the first PBSC collection after mobilisation. Included studies assessed associations between these outcomes and donor factors(such as age, gender, weight, ethnicity), mobilisation factors (G-CSF scheduling or dose), collection factors (venous access, processed blood volume) and laboratory factors (such as blood cell counts at baseline and after mobilisation). Results: The 51 eligible studies evaluated between 23 and 20,884 donors. 43 studies were retrospective, 32 assessed blood CD34+ cell concentration after mobilisation and 37 assessed CD34+ cell yield. In studies that recorded both outcomes, blood CD34+ cell concentration always predicted CD34+ cell yield. The most frequently assessed factor was donor age for which most studies reported that younger donors had a higher blood CD34+ cell concentration and CD34+ cell yield. Non-European ancestry was associated with both higher blood CD34+ cell concentration and yield although this finding was inconsistent. Conclusions: There remains poor consensus about the best predictors of blood CD34+ cell concentration and yield that requires further prospective study, particularly of the role of donor ancestry. The current focus on donor gender as a major predictor may require re-evaluation
异体干细胞捐献者干细胞动员和采集相关因素的范围审查
背景:健康的异基因造血干细胞捐献者经G-CSF动员和采集外周血后,CD34+细胞产量存在很大的个体差异。捐献者特征(包括性别和年龄、基线和采集前血液结果、动员因素和采集因素)与G-CSF动员后血液中CD34+细胞浓度和/或采集后CD34+细胞产量有关。由于报道这些关联的文献不尽相同,我们在此通过范围性文献综述来阐明 CD34+ 细胞浓度和产量的决定因素。材料与方法:在 MEDLINE、Embase、PubMed 和 Stem Cell Evidence 中检索了 2000 年至 2023 年间发表的研究。纳入标准是对异体捐献者进行G-CSF动员和外周血干细胞采集(PBSC)的研究。纳入的研究评估了这些结果与捐献者因素(如年龄、性别、体重、种族)、动员因素(G-CSF排期或剂量)、采集因素(静脉通路、处理血量)和实验室因素(如动员时和动员后的血细胞计数)之间的关联。结果:符合条件的 51 项研究对 23 至 20,884 名捐献者进行了评估。43项研究为回顾性研究,32项研究评估了动员后血液中CD34+细胞的浓度,37项研究评估了CD34+细胞的产量。在记录了这两项结果的研究中,血液 CD34+ 细胞浓度总是能预测 CD34+ 细胞产量。最常评估的因素是供者年龄,大多数研究报告称,年轻供者的血液 CD34+ 细胞浓度和 CD34+ 细胞产量较高。非欧洲血统与较高的血液 CD34+ 细胞浓度和产量有关,但这一结论并不一致。结论:关于血液 CD34+ 细胞浓度和产量的最佳预测因素仍未达成共识,这需要进一步的前瞻性研究,尤其是关于供体血统的作用。目前将捐献者性别作为主要预测因素的做法可能需要重新评估。
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