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Chokri Ben Lamine: Optimizing PBSC Donation in Hemoglobinopathy Carriers
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Jul 18, 2026, 13:42

Chokri Ben Lamine: Optimizing PBSC Donation in Hemoglobinopathy Carriers

Chokri Ben Lamine, Assistant Consultant at King Faisal Specialist Hospital and Research Center, shared a post on X:

“Sickle Cell Trait (HbAS) plus Alpha-Thalassemia Trait in a Stem Cell Donor: Key Precautions

Before donor clearance.

Confirm genotype:

  • Hb electrophoresis/HPLC (HbAS)
  • α-globin gene testing if α-thalassemia suspected
  • CBC, reticulocyte count, ferritin
  • Renal and liver function
  • Ensure no underlying anemia requiring investigation

Is donation contraindicated?

No. HbAS and α-thalassemia trait alone are not contraindications to peripheral blood stem cell (PBSC) donation if the donor is otherwise healthy.

Individual assessment remains essential.

G-CSF mobilization

Standard filgrastim (G-CSF) dosing:

  • 10 µg/kg/day SC for 4–5 days
  • Monitor symptoms closely.

Potential concerns in HbAS donors

  • Bone pain (common)
  • Rare vaso-occlusive–like complications reported
  • Splenic enlargement (rare splenic rupture)
  • Dehydration may increase sickling risk
  • Monitor oxygenation if symptomatic

Risk reduction

  • Maintain excellent hydration before, during, and after mobilization.
  • Avoid dehydration, extreme exercise, high altitude, and hypoxia.
  • Promptly evaluate chest pain, dyspnea, severe bone pain, abdominal pain, or neurologic symptoms.

During mobilization

  • Daily symptom assessment
  • CBC before collection
  • Consider chemistry panel if clinically indicated
  • Stop evaluation if severe toxicity develops

Apheresis. Generally safe.

Watch for:

  • Citrate-induced hypocalcemia
  • Vasovagal reactions
  • Adequate hydration throughout collection

Alpha-thalassemia trait

  • Usually does not affect donor eligibility.
  • Mild microcytosis alone is not iron deficiency.
  • Avoid empiric iron unless deficiency is documented.

Recipient considerations

  • HbAS donor grafts have demonstrated successful engraftment.
  • Inform the transplant team of donor hemoglobinopathy status for documentation and long-term follow-up.

Bottom line

  • HbAS ± α-thalassemia trait is generally acceptable for PBSC donation after careful donor evaluation.
  • Hydration, avoidance of hypoxia, and close monitoring during G-CSF mobilization and apheresis are the key precautions.

References

  • WBMT Consensus Recommendations⁠
  • FACT–JACIE International Standards for Hematopoietic Cellular Therapy⁠
  • EBMT Handbook (2024 edition)⁠.”

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Alpha-Thalassemia Chokri Ben Lamine G-CSF Health Hematology hemoglobinopathy Hemostasis Hemostasis News Hemostasis Today Medicine PBSC Sickle Cell Disease
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