# Leukapheresis to collect T cells for CAR T-cell manufacture

Source: https://onco.cc/protocols/car-t-apheresis/  
OnCo record `car-t-apheresis` (Protocol). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Every CAR T-cell treatment made from your own cells starts with leukapheresis: over a few hours, blood is taken from a vein, a machine keeps the white cells it needs, and the rest is returned. The date is booked with the manufacturer. Where possible it is done before more chemotherapy, which can weaken the T cells, and some recent treatments need a gap before collection.

## Summary

EBMT/JACIE 2019: book leukapheresis only once the manufacturer has confirmed a manufacturing slot. Any approved leukapheresis device may be used; the procedure resembles unmobilised collection for donor lymphocytes or photopheresis, and no device-specific protocol has been issued by device or CAR T-cell manufacturers. Sites must be qualified by the manufacturer; FACT-JACIE accreditation confirms a quality system. Collection is possible with absolute lymphocyte counts as low as 0.1 x 10^9/L, but manufacturing success is likelier above 0.5 x 10^9/L. Where disease allows, collect before salvage chemotherapy, because cumulative chemotherapy harms T-cell quality, and respect washout periods after recent treatments (EBMT Table 4, not read). Prior blinatumomab does not rule out anti-CD19 CAR T. Infectious disease markers are tested on the day of collection; sterility and cell counts (white cells, haematocrit, CD3+, viable CD45+) are reasonable quality control. Fresh products are kept at 2 to 8 degrees until shipped; one manufacturer (Novartis) requires on-site cryopreservation and accepts cells collected within the preceding 18 months.

SITC 2020 (LE: 4): prior allogeneic transplant, bispecific T-cell engagers or anti-CD19 or other antibodies do not exclude CAR T-cell therapy if the target antigen is still expressed. Bridging therapy starts only after collection (see the bridging protocol).

## Fields

- Kind: Protocol
- Last checked: 2026-11-11
- Also known as: leukapheresis for CAR T; T-cell collection; apheresis for CAR-T; starting material collection; unmobilised leukapheresis
- Tags: protocol; cell-therapy; car-t

## Connected records

- protocols: [Bridging therapy while CAR T cells are manufactured](https://onco.cc/protocols/car-t-bridging/), [Lymphodepleting chemotherapy before CAR T-cell infusion](https://onco.cc/protocols/car-t-lymphodepletion/), [Referral and eligibility assessment for CAR T-cell therapy](https://onco.cc/protocols/car-t-referral-and-eligibility/)
- technologies: [Apheresis and starting-material collection](https://onco.cc/technologies/apheresis-starting-material/), [Autologous CAR-T manufacturing, batch by batch](https://onco.cc/technologies/car-t-manufacturing-process/), [CAR-T cell therapy](https://onco.cc/technologies/car-t/)
- drugs: [Axicabtagene ciloleucel](https://onco.cc/drugs/axicabtagene-ciloleucel/), [Brexucabtagene autoleucel](https://onco.cc/drugs/brexucabtagene-autoleucel/), [Ciltacabtagene autoleucel](https://onco.cc/drugs/ciltacabtagene-autoleucel/), [Idecabtagene vicleucel](https://onco.cc/drugs/idecabtagene-vicleucel/), [Lisocabtagene maraleucel](https://onco.cc/drugs/lisocabtagene-maraleucel/), [Obecabtagene autoleucel](https://onco.cc/drugs/obecabtagene-autoleucel/), [Tisagenlecleucel](https://onco.cc/drugs/tisagenlecleucel/)
- terms: [Apheresis (leukapheresis)](https://onco.cc/terms/apheresis/), [The CAR-T pathway in lymphoma: referral, apheresis, bridging and the waiting](https://onco.cc/terms/lymphoma-tx-car-t-pathway/)

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