Access barriers to hematopoietic stem cell transplantation and CAR T-cells in US.

Cellular therapies, including hematopoietic stem cell transplantation (HCT) and chimeric antigen receptor (CAR) T-cell therapy, have undergone significant advancements, leading to broader indications and improved patient outcomes. Despite the progress, access remains inequitable, driven by disparities related to socioeconomic factors, healthcare infrastructure, and limitations associated with the products themselves. This review provides an overview of the current state of access to cellular therapies in the United States, with a focus on identifying barriers and exploring potential solutions. Many of these barriers are shared globally, including in low- and middle-income countries, but are not necessarily mirrored in other developed nations, where healthcare systems and funding models differ. Addressing these disparities will require action at many levels, including expanding community-based access, innovation in the manufacturing process, enhancing financial support, and implementing equity-focused initiatives. As cellular therapies continue to evolve, ensuring equitable access must remain a central priority to foster inclusiveness in medical innovation.