Lymphocytapheresis and Cellular Logistics for Car-t Therapy in Two Associated Brazilian Centers: a Descriptive Hemotherapy Analysis
Year: 2026
Type: article
Study design: Observational Study
Abstract: Introduction CAR-T cell therapy has revolutionized the treatment of relapsed or refractory hematologic malignancies and immune diseases. Before T-cell collection, these patients are usually heavily pretreated, with extensive chemotherapy exposure, high clinical complexity and comorbidities that may compromise lymphocytapheresis and cellular manufacturing. Despite the expansion of CAR-T therapy in Brazil, national data regarding hemotherapy procedures for CD3+ collection and cellular logistics remain limited. Methods This retrospective observational study included patients undergoing T-cell collection for CAR-T therapy between 2022 and 2026 in two associated Brazilian blood centers. Demographic characteristics, diagnosis, CD3+ cell yield, CAR-T product, transportation logistics, infusion status and process-related outcomes were analyzed. All lymphocytapheresis procedures were performed using the Spectra Optia system. Results Forty-one patients with a registered collection date were evaluated. Median age was 62 years (24–84), and 26 patients were male (63.4%). Diagnoses included non-Hodgkin lymphoma in 20 patients (48.8%), multiple myeloma in 18 (43.9%), acute lymphoblastic leukemia in 1 (2.4%) and autoimmune diseases in two (4.9%). Median collected CD3+ cell yield was 7.40 × 10⁹ cells (0.002–26.12 × 10⁹). Regarding CAR-T products, 14 patients received axicabtagene ciloleucel (34,1%), 17 ciltacabtagene autoleucel (41,5%), 8 tisagenlecleucel (19,5%) and two rapcabtagene (4,9%) autoleucel. Cellular products were shipped through specialized logistics services with temperature control and traceability. All products intended for ciltacabtagene autoleucel were transported cryopreserved. Overall, 26 patients (63.4%) underwent CAR-T infusion, whereas 5 (12.2%) died before infusion, 8 (19.5%) remained awaiting manufacturing or infusion and two (4.9%) experienced manufacturing or collection failure. Median time from collection to infusion was 56 days (31–401). Conclusion This two-center experience highlights the critical role of hemotherapy throughout the CAR-T process, including lymphocytapheresis, product handling, cryopreservation and cellular logistics. These findings reinforce the complexity of this population and the importance of integration among hemotherapy services, cellular therapy programs and manufacturing centers to optimize CAR-T access in Brazil.
Language: English
Topic: CAR-T cell therapy research
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7223114547