Cellular therapy treatment has been around for 50 years, getting its start with hematopoietic stem cell transplant bone marrow transplant (HSCT) as the treatment of blood cancers. In 2017, a new type of treatment called Chimeric Antigen Receptor T-cell (CAR-T) therapy, has been effective for many patients with far advanced relapsed and refractory blood cancers, and may be used increasingly in the future to supplant BMT. CAR-T uses a patient’s reengineered T-cells to seek and destroy cancer cells in the patient’s body. UPHS, like many other established BMT centers, had to prepare by building the infrastructure to onboard these therapies. Development of a CAR-T therapy infrastructure has created issues that were unique from BMT, including the high dollar cost of the therapy that puts increased risk on centers when delivering this care to patients.