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

Current guidelines recommend the use of multi-lumen central venous access for the infusion of chimeric antigen receptor (CAR) T-cells for patients with large B-cell lymphoma (LBCL) [ 1 , 2 ]. While options include placement of a peripherally inserted central catheter (PICC), central venous catheter (CVC), or implanted venous access via a port-a-cath [ 1 ], PICC use is predominant [ 2 , 3 ], mainly due to hypothetical concern for potential deleterious effects of shear stress enacted on CAR T-cells when infused through the angled port Huber needle, as these cells may be more susceptible to mechanical stresses [ 4 , 5 ]. However, there is no current data to support this practice. Investigating this question is clinically relevant, because most patients may already have a port due to prior systemic therapies, and the addition of a PICC line and possible removal of the port frequently represents an inconvenience for these patients.