T cell collection

CAR T-cells are made from your own T cells, so your healthcare team will first need to collect and separate T cells from your blood.

This process is called apheresis (AY-fur-EE-sis). It’s sometimes also known as leukapheresis (LOO-kuh-fur-EE-sis). This is a medical procedure involving the separation and removal of certain blood cells.

During apheresis blood is temporarily removed and filtered through a special machine known as an apheresis machine. This machine separates your T cells from your other blood cells before returning the rest of your blood back into your bloodstream. This process usually takes between 3 – 6 hours.

Once the apheresis is completed, your T cells are sent to a laboratory, ready to be turned into CAR T-cells.

What happens during apheresis

During the procedure you will be seated in a comfortable, reclining chair, which may have cushions and a blanket. A nurse will be with you the whole time and you may also be allowed visitors.

The nurse will place a sterile needle into the vein in each of your arms. These needles are connected to transparent tubes which lead to the apheresis machine.

The machine draws blood from one of your arms and this blood passes through the machine, which spins as it separates your T cells. The blood which isn’t collected flows back into your other arm.

During this process your blood is treated with medicines to avoid blood clots.

When the procedure has finished the needles are removed and pressure dressings are applied.

Safety and side effects

Serious complications of apheresis are rare. You may experience lightheadedness and/or sweating as your blood is removed, but this does not usually last long. Other side effects can include low blood pressure and cramping.

While it is a generally painless procedure, you may feel some discomfort where the needles are placed in your veins. You may be given the option to have a local anaesthetic before the procedure, which will numb the area of your arms where the needles are placed.

How to prepare

There isn’t a lot you need to do to prepare for apheresis, but there are some things that may make your experience more comfortable.

1. Wear loose and comfortable clothing with short sleeves or sleeves that roll up easily to allow easy access to both of your arms.
2. Bring items that make you feel comfortable or help pass the time such as music, books, magazines or a tablet you can watch something on.
3. Ask someone to come along and keep you company. Visitors are allowed during apheresis, although they may be asked to leave for a few minutes during the start and end of the procedure.