Scoping Review of Factors Associated with Stem Cell Mobilization and Collection in Allogeneic Stem Cell Donors

There is wide interindividual variation in the efficacy of CD34⁺ cell mobilization and collection in healthy allogenic hematopoietic stem cell donors. Donor characteristics, blood cell counts, and various factors related to mobilization and collection have been associated with blood CD34⁺ cell count and CD34⁺ cell yield after granulocyte colony-stimulating factor (G-CSF) mobilization and collection. Given the heterogenous nature of the literature reporting these associations, in this scoping review we clarify the determinants of CD34⁺ count and yield. Studies published between 2000 and 2023 reporting allogeneic donors undergoing G-CSF mobilization and peripheral blood stem cell (PBSC) collection were evaluated. Eligible studies were those that 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, sex, weight, ethnicity), mobilization factors (G-CSF scheduling or dose), collection factors (venous access, processed blood volume [PBV]) or laboratory factors (blood cell counts at baseline or after mobilization). The 52 studies evaluated between 15 and 20,884 donors. Forty-three studies were retrospective, 33 assessed blood CD34⁺ cell counts, and 39 assessed CD34⁺ cell yield from PBSCs. 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 donors of non-European ancestry had higher blood CD34⁺ cell counts after mobilization and higher CD34⁺ cell yields from collection. The poor consensus about the best predictors of blood CD34⁺ cell count and yield necessitates further prospective studies, particularly of the role of donor ancestry. The current focus on donor sex as a major predictor requires re-evaluation.