CAR T-cell therapy is available at more than 100 authorized cancer centers across the United States, with additional centers in Europe, Asia, Canada, and Australia. Most are large academic medical centers or specialized cancer hospitals, though the treatment is gradually expanding to community oncology settings. Finding a center depends on the specific cancer being treated, whether you qualify for an approved product or a clinical trial, and how far you can travel.
What CAR T-Cell Therapy Treats
The FDA has approved several CAR T-cell products, each for specific blood cancers. Understanding which product applies to your situation helps narrow down which centers to contact, since not every center carries every product.
- Large B-cell lymphoma: Two approved products treat adults whose lymphoma has returned or not responded after two or more prior treatments. This includes diffuse large B-cell lymphoma, high-grade B-cell lymphoma, and primary mediastinal large B-cell lymphoma.
- Follicular lymphoma: One product is approved for adults whose follicular lymphoma has come back after at least two rounds of prior treatment.
- Acute lymphoblastic leukemia (ALL): One product treats patients up to age 25 with B-cell ALL that has relapsed or not responded to standard treatment.
- Multiple myeloma: Two products are approved for adults whose myeloma has returned after prior therapies, including certain standard drug combinations.
If your cancer doesn’t match one of these approved uses, clinical trials may offer access to newer CAR T-cell therapies targeting other cancers, including some solid tumors.
How Centers Get Authorized
Not every hospital can administer CAR T-cell therapy. Until recently, the FDA required treatment centers to be specially certified under a safety program called REMS (Risk Evaluation and Mitigation Strategies). This meant hospitals needed specific staff training, protocols for managing serious side effects, and immediate on-site access to certain emergency medications.
The FDA has since eliminated the REMS requirement for approved CAR T-cell products, determining that the existing product labeling, which includes boxed warnings about cytokine release syndrome and neurological side effects, provides adequate safety information. This change could open the door for more hospitals to offer treatment over time, though in practice, centers still need the infrastructure, expertise, and accreditation to handle these complex therapies safely.
The Foundation for the Accreditation of Cellular Therapy (FACT) accredits institutions that meet quality standards for cellular therapy programs. FACT-accredited centers span the country, from major cancer hospitals in cities like New York, Houston, and Los Angeles to programs at regional medical centers in states like Ohio, Florida, Illinois, and Pennsylvania.
Where to Find Centers in the U.S.
The more than 100 authorized U.S. centers are concentrated at academic medical centers and National Cancer Institute-designated cancer centers. Major institutions like Memorial Sloan Kettering, MD Anderson, the Mayo Clinic, Dana-Farber, and UPMC Hillman Cancer Center are among the most experienced. But authorized sites also include large community hospital systems like AdventHealth in Orlando, Allegheny Health Network in Pittsburgh, and Advocate Lutheran General Hospital near Chicago.
Each CAR T-cell product manufacturer maintains a searchable list of certified treatment centers on its website. The fastest way to find a center near you is to look up the specific product your oncologist has discussed and check the manufacturer’s site for a location finder. Your oncologist can also refer you directly.
For pediatric patients, options are more limited. CAR T-cell therapy for children and young adults with leukemia requires centers with specialized pediatric oncology teams. MSK Kids at Memorial Sloan Kettering is one of the most experienced pediatric CAR T programs in the world, with teams specifically trained in caring for children and young adults throughout the process. Children’s hospitals like Akron Children’s Hospital also hold cellular therapy accreditation. Pediatric centers often offer clinical trials for cancers beyond the current approved uses, including some solid tumors.
International Availability
CAR T-cell therapy is available in Europe, where several products have been approved by the European Medicines Agency. The UK’s National Health Service covers approved CAR T treatments at designated specialist centers. Countries across Asia, including China, Japan, and India, also offer CAR T therapies, though availability and reimbursement vary widely. Canada, Australia, and New Zealand have authorized centers as well.
A 2023 global survey by the Worldwide Network for Blood and Marrow Transplantation found responses from centers across North America, Asia, Europe, South and Central America, Australia and New Zealand, and Africa. Costs in Europe and North America are roughly comparable, while pricing in Asia shows more variability. Outside of approved commercial products, China in particular has a large number of CAR T clinical trials underway.
Insurance and Cost Considerations
CAR T-cell therapy is one of the most expensive cancer treatments available, with list prices for the therapy itself typically ranging from $373,000 to over $475,000, not including hospitalization, monitoring, and supportive care. Coverage varies significantly by insurer.
Medicare covers CAR T-cell therapy when it is administered at a healthcare facility that was enrolled in the FDA’s REMS program (or meets equivalent standards) and used for an FDA-approved indication or a use supported in CMS-approved drug reference guides. If those conditions aren’t met, Medicare will not cover the treatment. Private insurers generally follow similar criteria but may have additional requirements like prior authorization or referral to specific in-network centers.
Because so few centers offer this therapy relative to the number of patients who need it, many people must travel. The practical reality is that you may need to stay near the treatment center for 30 days or more after infusion. This acute recovery period allows the medical team to monitor for serious side effects like cytokine release syndrome, which can cause high fevers, dangerously low blood pressure, and difficulty breathing, or neurological complications like confusion and seizures. Some patients require extensions beyond the initial 30 days if complications arise.
Staying Close to Your Treatment Center
Most centers recommend that you remain within close distance of the facility for at least a month after your infusion. This means arranging temporary housing if you’ve traveled for treatment. Many major cancer centers have affiliated housing programs, such as Hope Lodges run by the American Cancer Society, which provide free or reduced-cost lodging for cancer patients and caregivers. Hospital social workers at your treatment center can help coordinate these resources.
Plan for a caregiver to be with you throughout this period. You will not be able to drive for at least eight weeks after treatment, and the recovery period can involve multiple follow-up visits per week. Some insurance plans and assistance programs cover travel, meals, and accommodations, so ask both your insurer and the treatment center’s financial counselors what support is available before you begin.
Finding Clinical Trials
If you don’t qualify for an approved CAR T product, or if your cancer type isn’t covered by current approvals, clinical trials may be an option. ClinicalTrials.gov lists active CAR T studies with their locations, eligibility criteria, and contact information. You can search by cancer type and filter by location to find trials near you. Many trials are testing next-generation CAR T therapies that target new proteins on cancer cells, use donor cells instead of the patient’s own (sometimes called “off-the-shelf” CAR T), or treat cancers that current products don’t address, including some solid tumors and autoimmune diseases.
Your oncologist can help you identify which trials you might qualify for. Large academic centers tend to run the most trials, which is another reason patients often travel to these institutions even when community cancer centers are closer to home.