Hematologist
CION Cancer Clinics
Apheresis for CAR-T: what happens on collection day | CION Cancer Clinics
Collection for CAR-T usually takes three to six hours. You sit or lie while a machine draws your blood, keeps some white cells, and returns the rest. Most people go home the same day with a caregiver. This page explains how to prepare, what you may feel, which symptoms to report at once, and what happens to your cells after they leave the room. At CION Cancer Clinics, our haematology team assesses whether a transplant or CAR-T fits your situation and coordinates care with qualified centres.
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Medically reviewed by Dr. Basudev PokhrelConsultant Haematologist · last reviewed September 2026, next review due September 2027
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The short answer
What happens on the CAR-T collection day?
You lie on a bed or reclining chair for a few hours while a machine draws your blood, keeps some of your white cells, and returns the rest to you. It is called leukapheresis, and most people go home the same day.
Why the cells are collected
CAR-T is made from your own T cells, a type of white blood cell that fights infection. The collected cells are packed, often frozen, and sent to a laboratory. There they are changed so they can recognise the cancer, grown in large numbers, and later returned to you as a single drip.
How long it takes
Most collections take somewhere between three and six hours. Some people need a second session the next day if not enough cells were gathered the first time. That is common and does not mean something went wrong with your treatment.
Where it happens
Collection is done at the centre giving the CAR-T, or at a blood bank it works with. CION does not collect cells in-house. Our haematology team prepares your reports and coordinates with the treating centre so the day is planned well ahead.
On the day
What happens from arrival to going home?
Blood tests first
Your blood counts are checked, often that morning. The team needs enough white cells in your blood for the collection to be worthwhile. If the counts are too low, the day may be moved.
The line is placed
A needle goes into a vein in each arm, one to take blood out and one to return it. If your arm veins are small, a thin tube may be placed in a larger vein in the neck or chest instead.
The machine runs
Blood flows into the machine, which spins it to separate the white cells. The rest goes back to you. A medicine is added to stop the blood clotting in the tubing. A nurse stays with you throughout.
Checks and going home
The line is removed, or kept if another session is planned. You rest briefly, your counts may be checked again, and you usually leave with a caregiver the same day.
Not sure whether this applies to you?
Ask an oncologistGetting ready
How should you prepare the day before?
Small things make a long session easier. Your treating centre will give you its own written instructions, and those come first.
Eat and drink normally
Unless told otherwise, have a proper breakfast and drink plenty of water the evening before and that morning. Being well hydrated makes veins easier to use.
Dairy foods such as milk or curd may be suggested, as they help with the tingling some people feel.Ask about your medicines
Some medicines, including steroids and certain cancer drugs, can lower the number of T cells collected. Ask the treating team which of your medicines matter. Do not stop or change any medicine yourself.
What to bring
Pack for a long sit with one arm or both arms kept still.
Useful to carry
- Loose clothes with short or wide sleeves
- A shawl or light blanket
- Phone, charger and earphones
- All reports and a medicine list
Bring a caregiver
You may feel tired afterwards, and your hands may be busy during the session. A family member can help you eat, drink and reach the toilet, and should take you home. Do not plan to drive yourself.
!
Tell the nurse straight away
Tingling around the lips or in the fingers, muscle cramps, dizziness, feeling faint, chest discomfort or feeling very cold during the collection all need a nurse at once. They are usually easy to settle by slowing the machine or giving calcium. Do not sit quietly and wait for it to pass. After you are home, go to the nearest emergency department or call 108 if you have a high fever, heavy bleeding from the line site or trouble breathing.
Leave a number, we will call you
One field. No form to fill in, and no charge for the call.
Commonly believed
What do families worry about that is not true?
"They are taking out all his blood."
Only a small amount of blood sits outside the body at any time. The machine keeps a small share of white cells and returns everything else. Your body replaces the collected cells over the following days.
"A second session means the treatment has failed."
A repeat session is a routine way to reach the number of cells the laboratory needs. It says little about how well CAR-T will work later on.
"Collection day is the treatment."
Nothing is treated on this day. The CAR-T drip comes weeks later, after the cells are made and after a short course of chemotherapy. You still need to follow your plan for the cancer in the meantime.
"It is the same as donating blood."
It is longer, uses a machine and needs a blood test beforehand. The feeling in the chair is similar for most people, but the preparation and the watching are more careful.
Afterwards
What happens after your cells leave the room?
Your cells are labelled with your details, checked and shipped to the manufacturing laboratory. The wait that follows usually runs to a few weeks, and the time depends on the product and the laboratory.
How you may feel
Tiredness for the rest of the day is common. Some people have a bruise or soreness where the needles went in. If a tube was placed in the neck or chest, keep the dressing dry and clean as the nurse shows you. Most people return to their normal routine the next day.
Who this may not go smoothly for
Very low blood counts, recent strong chemotherapy, an active infection or veins that are hard to use can all make collection slower or less successful. The team may then plan a different date or a different line.
What this page cannot tell you
It cannot tell you whether enough cells will be collected, or whether the cells will grow well in the laboratory. Those depend on your blood and your earlier treatment. Ask the treating centre how they will tell you if a second collection is needed.
On your paperwork
What do the words on the forms mean?
- Leukapheresis
- Collecting white blood cells from your blood with a machine, then returning the rest.
- Lymphocyte count
- The number of lymphocytes, the family of white cells that includes T cells, in your blood report.
- CD3 count
- A measure of T cells specifically. Some centres check it before or during collection.
- Anticoagulant
- A medicine added in the machine to stop blood clotting in the tubing. It can cause brief tingling.
- Central line
- A thin tube placed in a large vein, used when arm veins are too small.
- Chain of identity
- The labelling and tracking that makes sure the cells returned to you are your own.
Questions we are asked
Common questions about the collection day
Does the collection hurt?
The needles feel like an ordinary blood test when they go in. After that most people feel little more than stiffness from sitting still. Some notice tingling in the lips or fingers from the medicine that stops clotting. Tell the nurse, as it usually settles quickly.
Can I eat and use the toilet during the session?
Usually you can eat light snacks and drink during the collection. Going to the toilet may mean pausing the machine, so empty your bladder before it starts. A caregiver sitting with you makes eating and drinking much easier when your arms need to stay still.
Can I watch TV or use my phone?
Yes, if at least one hand is free. With needles in both arms, it is easier to listen to something or have someone hold the phone. Bring earphones and a charger, because the session can run for several hours.
What if my blood counts are too low on the day?
The team may delay the collection until your counts recover, or go ahead and plan an extra session. This is a judgement based on your reports and how fast the disease is moving. Ask them what they will do if the counts are low, so you are not surprised.
Should my father stop his medicines before collection?
Only if the treating team tells him to. Some medicines can reduce the cells collected, and the team may ask for a gap. They will tell him which ones and for how long. Stopping anything on your own can be unsafe, especially steroids or blood thinners.
Can I go to work the next day?
Many people feel well enough to return to light work the next day. If a line was placed in the neck or chest, heavy lifting may need to wait. Remember that the weeks after the CAR-T drip usually need time off, so plan leave for that period too.
Is the collection covered by insurance or a scheme?
It is usually counted as part of the CAR-T package at the treating centre, but cover varies. Check with your insurer, and ask about Aarogyasri, PM-JAY, CGHS, ECHS or EHS rules, which change over time. Get a written estimate that says whether collection is included.
How does CION help with this step?
CION does not collect cells or make CAR-T. Our haematology team reviews your reports, discusses the case at a tumour board and coordinates with a qualified CAR-T centre. We help you arrive at the collection day with the right reports and a clear list of questions.
Your Haematologist
Meet CION's haematologist. One specialist for your blood report and your plan.
Dr. Basudev Pokhrel reviews blood counts, transfusion needs and blood disorders, and works with the CION tumour board on blood cancers.
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Patient stories
Hear it from people we have treated
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Accreditation and empanelment
- NABH
- NABL
- ISO 9001:2015
- ArogyaSri empanelled
- CGHS accepted
- ECHS accepted
- EHS accepted
- Major cashless insurers
Paying for it
Insurance, schemes and payment
What you actually pay usually differs a great deal from the sticker figure.
AarogyasriEmpanelled. Bring the card and a referral where you have one.
CGHS / ECHS / EHSAccepted at CION centres for eligible treatment.
Cashless insuranceMost major insurers are empanelled. Pre-authorisation is handled by our desk.
Self-payItemised estimate given before treatment starts. No EMI scheme exists.
Where to find us
Our centres in and around Hyderabad
Addressed by landmark, because that is how this city navigates. A haematology consultation can be booked at any of these centres through one helpline, and your team will tell you where each test or treatment takes place.
Warangal
Vizag
Sources
- Leukaemia & Lymphoma Society — Chimeric Antigen Receptor (CAR) T-Cell Therapy
- National Cancer Institute — CAR T Cells: Engineering Patients' Immune Cells to Treat Their Cancers
- Cancer Research UK — CAR T-cell therapy
- National Health Mission — National Health Mission
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
CAR-T: The GapsThe full guide to the CAR-T pathwayThe Manufacturing Wait and What Happens MeanwhileWhat happens after your cells are sent awayWhen CAR-T Manufacturing FailsIf the cells do not grow as plannedCaregiver Requirements During CAR-TWhat the family member with you will need to doBlood counts during chemotherapyReading the counts checked before collection
Talk to us
Preparing for CAR-T cell collection?
Share your reports with CION's haematology team. We review your case and coordinate with a qualified CAR-T centre so collection day is planned well.