AABB2026: Promoting Equity for Donors with Sickle Cell Trait

Current restrictions on peripheral blood stem cell (PBSC) collection for donors with sickle cell trait (SCT) may expose donors to unnecessary risks and contribute to health care inequities, according to a presentation during the “Promoting Equity in Transfusion Medicine” session at the 2026 AABB Annual Meeting. 

During the session, co-presenter Brian J. Carney, MD, addressed misconceptions and health care equity issues surrounding SCT. He emphasized that SCT is a carrier state, not sickle cell disease (SCD), and that the risks associated with mobilizing stem cells in patients with SCD should not automatically be applied to individuals with SCT.   

Carney noted that current guidance from NMDP and the Worldwide Network for Blood and Marrow Transplantation (WBMT) restricts PBSC collection from donors with SCT while permitting bone marrow harvest. 

Available studies suggest that mobilization with granulocyte colony-stimulating factor (G-CSF) is generally well tolerated in donors with SCT, with no reported vaso-occlusive crises or acute chest syndrome in the studies reviewed. Carney noted that the evidence remains limited, with most studies involving small or retrospective cohorts. 

He also cited research showing that bone marrow harvest carries approximately three times the risk of serious donor complications compared with PBSC collection. These findings were based on the broader donor population rather than individuals with SCT specifically. 

Carney and colleagues are investigating these questions through the SCT Collect study, a multicenter retrospective study examining SCT status, mobilization strategies and collection-related complications. The study has collected data from 14 centers involving more than 1,700 patients, with findings scheduled to be presented Monday, Oct. 19, during Carney’s plenary oral abstract session, “Safety of Peripheral Blood Stem Cell Collection in Individuals with Sickle Cell Trait.” 

During the Q&A, an audience member asked why organizations such as NMDP and the NCAA continue to maintain restrictions or screening policies for individuals with SCT. Carney responded that some policies are based on limited or poor-quality evidence, including findings from individual cases that have been applied more broadly. 

Carney encouraged institutions to review SCT-related restrictions in their donor eligibility and collection protocols and evaluate the potential consequences of alternative collection approaches. 

“Restrictive collection policies may expose donors with SCT to increased potential risks, and additional research is essential to guide safe, effective and equitable stem cell collection practice,” he told attendees. “Policies intended to promote safety must be evaluated not only for the harms they are intended to prevent, but also for the harms and disparities that they may cause.”