Poor harvest of peripheral blood stem cells in donor with thalassemia trait

Here, we present a case report detailing a failed harvest from a 3-year-old child, a sibling-matched related donor for a patient with thalassemia undergoing ABO-incompatible hematopoietic stem cell transplant. The initial apheresis procedure, with the donor having an hematocrit of 29.4 and a peripheral blood CD34 count of 72 cells/µl, resulted in a poor harvest, exhibiting an inadequate collection efficiency of 21% for the apheresis procedure. We here analyzed the factors that overt red cell abnormalities (low mean corpuscular volume [MCV]) in donor may account for failures to collect the circulating CD34+ cells by standard apheresis variables despite adequate mobilization. Individuals with low MCV who are at risk of stem cells harvest failure can be identified prior to apheresis, and poor harvest can be avoided by adjustment of the apheresis variable.