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Currently, there are two FDA\u2010approved CD19\u2010directed CAR\u2010T cell products for the treatment of adults with R\/R B\u2010ALL. Despite high remission rates following CD19 CAR\u2010T cell therapy in R\/R B\u2010ALL, remission durability remains limited in most adult patients, with relapse observed frequently in the absence of additional consolidation therapy. Furthermore, the burden of CAR\u2010T cell toxicity remains significant in adults with R\/R B\u2010ALL and further limits the wide utilization of this effective therapy. In this review, we discuss patient and disease factors that are linked to CAR\u2010T cell therapy outcomes in R\/R B\u2010ALL and strategies to optimize durability of response to reduce relapse and mitigate toxicity in the adult population. We additionally discuss future approaches being explored to maximize the benefit of CAR\u2010T in adults with B\u2010ALL.<\/jats:p>","DOI":"10.1111\/ejh.14109","type":"journal-article","created":{"date-parts":[[2023,9,29]],"date-time":"2023-09-29T13:56:27Z","timestamp":1695995787000},"page":"236-247","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Optimizing <scp>CAR\u2010T<\/scp> cell therapy in adults with <scp>B\u2010cell<\/scp> acute lymphoblastic leukemia"],"prefix":"10.1111","volume":"112","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6383-3777","authenticated-orcid":false,"given":"Vaibhav","family":"Agrawal","sequence":"first","affiliation":[{"name":"Department of Hematology and Hematopoietic Cell Transplantation, Gehr Family Center for Leukemia Research City of Hope National Medical Center  Duarte California 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