CO065 | THROMBOTIC RISK IS NOT UNIFORM ACROSS APHERESIS SETTINGS: INSIGHTS FROM CAR-T LYMPHOCYTAPHERESIS AND AUTOLOGOUS STEM CELL COLLECTION
Abstract
Background. Pericatheter thrombosis (PCT) is a recognized complication of large-bore venous catheters used for cell collection. An incidence of approximately 1.8% has been reported for Mahurkar catheters in peripheral blood stem cell collection. Data in patients undergoing lymphocytapheresis for CAR-T therapy are limited. This study evaluates PCT in this setting and compares thrombotic events with those observed in autologous stem cell collection. Methods. A retrospective single-centre analysis included 62 patients undergoing CAR-T lymphocytapheresis with a Mahurkar catheter (September 2019–October 2025). During the same period, 127 patients underwent autologous stem cell collection; 62 required a Mahurkar catheter, and a subset of 21 with comparable diseases was analyzed. Within the CAR-T cohort, analyses compared (1) PCT vs non-PCT and (2) any thrombosis vs no thrombosis. A third analysis compared CAR-T and autologous cohorts. Continuous variables were analyzed with Student’s t-test and categorical variables with chi-square or Fisher’s exact test. Results. In the CAR-T cohort, PCT occurred in 5/62 patients (8%) and 13/62 (21%) developed overall thrombosis. No variable was significantly associated with PCT, although platelet count showed a borderline trend (p = 0.061). Procedural difficulty was more frequent in PCT cases (66% vs 18%), without statistical significance. In the autologous cohort, no PCT was observed (0/21), while 2 patients (9.5%) developed thrombosis at non-catheter sites. Compared to the autologous cohort, CAR-T patients showed lower platelet count (p < 0.0001), hemoglobin (p = 0.0276), and differences in white blood cell count (p = 0.045). Disease status also differed significantly, with all autologous patients in partial or complete response (p < 0.001). Conclusions. PCT was more frequent in CAR-T lymphocytapheresis than in autologous stem cell collection. This difference appears to reflect underlying patient characteristics rather than procedural factors. CAR-T patients represent a distinct population with more advanced disease and altered hematological profiles. Thrombotic risk should not be considered uniform across apheresis settings, supporting tailored risk assessment and preventive strategies.
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BibTeX
@article{pansini2026co065,
title = {{CO065 | THROMBOTIC RISK IS NOT UNIFORM ACROSS APHERESIS SETTINGS: INSIGHTS FROM CAR-T LYMPHOCYTAPHERESIS AND AUTOLOGOUS STEM CELL COLLECTION}},
author = {Ilaria Pansini},
journal = {Bleeding, Thrombosis and Vascular Biology},
year = {2026},
month = oct,
url = {https://www.btvb.org/btvb/article/view/767},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - CO065 | THROMBOTIC RISK IS NOT UNIFORM ACROSS APHERESIS SETTINGS: INSIGHTS FROM CAR-T LYMPHOCYTAPHERESIS AND AUTOLOGOUS STEM CELL COLLECTION
AU - Ilaria Pansini
PY - 2026
DA - 2026/10/26
JO - Bleeding, Thrombosis and Vascular Biology
UR - https://www.btvb.org/btvb/article/view/767
AB - Background. Pericatheter thrombosis (PCT) is a recognized complication of large-bore venous catheters used for cell collection. An incidence of approximately 1.8% has been reported for Mahurkar catheters in peripheral blood stem cell collection. Data in patients undergoing lymphocytapheresis for CAR-T therapy are limited. This study evaluates PCT in this setting and compares thrombotic events with those observed in autologous stem cell collection. Methods. A retrospective single-centre analysis included 62 patients undergoing CAR-T lymphocytapheresis with a Mahurkar catheter (September 2019–October 2025). During the same period, 127 patients underwent autologous stem cell collection; 62 required a Mahurkar catheter, and a subset of 21 with comparable diseases was analyzed. Within the CAR-T cohort, analyses compared (1) PCT vs non-PCT and (2) any thrombosis vs no thrombosis. A third analysis compared CAR-T and autologous cohorts. Continuous variables were analyzed with Student’s t-test and categorical variables with chi-square or Fisher’s exact test. Results. In the CAR-T cohort, PCT occurred in 5/62 patients (8%) and 13/62 (21%) developed overall thrombosis. No variable was significantly associated with PCT, although platelet count showed a borderline trend (p = 0.061). Procedural difficulty was more frequent in PCT cases (66% vs 18%), without statistical significance. In the autologous cohort, no PCT was observed (0/21), while 2 patients (9.5%) developed thrombosis at non-catheter sites. Compared to the autologous cohort, CAR-T patients showed lower platelet count (p < 0.0001), hemoglobin (p = 0.0276), and differences in white blood cell count (p = 0.045). Disease status also differed significantly, with all autologous patients in partial or complete response (p < 0.001). Conclusions. PCT was more frequent in CAR-T lymphocytapheresis than in autologous stem cell collection. This difference appears to reflect underlying patient characteristics rather than procedural factors. CAR-T patients represent a distinct population with more advanced disease and altered hematological profiles. Thrombotic risk should not be considered uniform across apheresis settings, supporting tailored risk assessment and preventive strategies.
SN - 2785-5309
ER -