A Saudi national panel of hematologists set out clinical eligibility criteria and health-system frameworks to expand adult access to CAR T-cell therapy for relapsed or refractory B-cell acute lymphoblastic leukemia. The guidance is intended to standardize patient selection and pathway readiness as CAR T adoption grows beyond established centers. For developers and service providers, the report signals where operational bottlenecks—capacity, governance, and referral workflows—may be addressed first as regulators and health systems prepare for scaling.