Clinical Report: Safety and effectiveness of implanted ports for CAR T-cell infusion

Overview

This single-center retrospective analysis compared implanted ports with PICC/CVC access for commercial CAR T-cell infusion in 504 patients with large B-cell lymphoma. Infection and prolonged cytopenia rates and response rates were similar between groups; venous thromboembolism was less frequent with ports. The supplied article excerpt does not include the complete progression-free survival results.

Background

Guidelines cited by the authors recommend multi-lumen central venous access during CAR T-cell infusion, and PICCs remain commonly used. The authors describe concern that shear stress from infusion through an angled port needle could affect CAR T cells, but state that data supporting this concern were unavailable. Because many patients may already have an implanted port from prior systemic therapy, adding a PICC and potentially removing the port can be inconvenient. This study assessed the safety and efficacy of ports compared with PICC/CVC access in patients with LBCL.

Data Highlights

Key Findings

• The retrospective cohort included 504 patients treated from January 2018 through March 2025; 202 received CAR T-cell infusion through a port and 302 through a PICC or CVC.

• Baseline characteristics were comparable except that refractory disease was more frequent in the port group (76.2% vs 68.1%; p = 0.048).

• CRS occurred in 87.5% of patients, including grade 3–4 CRS in 12.5%; ICANS occurred in 56.2%, including grade 3–4 ICANS in 35.1%.

• Line-associated infections (4.8% overall) and prolonged cytopenia (54.2% overall) were reported at comparable rates between access groups.

• VTE was less frequent in the port group than in the PICC/CVC group (3.0% vs 9.3%; p = 0.006).

• Day-30 and day-90 complete metabolic response rates did not differ significantly between groups (52.2% vs 56.7%, p = 0.325; and 46.1% vs 50.5%, p = 0.351, respectively).

• Median PFS was 6.47 months overall; median PFS did not differ significantly between the port and PICC/CVC groups (5.6 vs 6.7 months; p = 0.25). Median OS was 20.0 months overall and also did not differ significantly between groups (16.6 vs 23.6 months; p = 0.13).

• Multivariable analyses found no significant association between access type and toxicity or efficacy endpoints, except for an association between port use and lower VTE rates.

Clinical Implications

In this single-center retrospective cohort, infection, prolonged cytopenia, response, PFS, and OS outcomes did not differ significantly between port and PICC/CVC access groups; VTE was less frequent with ports. Multivariable analyses found no significant association between access type and toxicity or efficacy endpoints except for lower VTE rates with port use. These are observational findings and do not establish comparative causality.

Conclusion

The study reports comparable response and selected safety outcomes with port versus PICC/CVC access for CAR T-cell infusion in LBCL, with a lower observed VTE rate in the port group. Interpretation is limited to the retrospective, single-center data provided.

Related Resources & Content

1. Blood Cancer Journal, 2026 -- Safety and efficacy of port use for CAR T-cell infusion in large B-cell lymphoma

2. ASCO Publications, 2022 -- Real-world analysis of safety and efficacy of CAR T-cell therapy in patients with lymphoma with decreased renal function

3. ASCO Publications, 2024 -- Safety and feasibility of outpatient CAR-T therapy: A single center analysis

4. ASCO Publications — Efficacy and safety of commercial CD19 CAR-T (inaticabtagene autoleucel) in relapsed/refractory extramedullary B-ALL: A large multicenter real-world study.

5. ASCO Publications — Late infectious complications after CD19-directed chimeric antigen receptor T-cell (CAR-T) therapy for large B-cell lymphomas (LCBL): Real-world predictors and outcomes.

6. Safety and efficacy of port use for CAR T-cell infusion in large B-cell lymphoma

7. NCCN Guidelines Version 1.2025

8. NCCN Guidelines Version 1.2025

9. CD19 CAR-T cell therapy in large B-cell lymphoma: clinical evidence, resistance, toxicity, and precision strategies - PMC

10. Safety and efficacy of port use for CAR T-cell infusion in large B-cell lymphoma | Blood Cancer Journal