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Conventional multiagent chemotherapy and bispecific antibody therapy may induce remission; however, relapse rates remain high and overall survival is poor. Chimeric antigen receptor T\u2010cell (CAR\u2010T) therapy provides durable, deep complete remission, and long\u2010term cures in relapsed and refractory B\u2010ALL. However, with this new treatment modality, 10%\u201330% of patients do not achieve remission, and over 50% experience relapse after therapy. Currently, there are two approved CD19\u2010specific CAR\u2010T cell constructs in B\u2010ALL, Tisagenlecleucel and Brexucabtagene Autoleucel by the United States Food and Drug Administration, and the European Medicines Agency (EMA). In this review, we discuss patients, disease, and CAR\u2010T predictors of outcomes in B\u2010ALL. We describe the two approved CD19\u2010directed CAR\u2010T cell products, review the current literature, and discuss factors associated with high risks of therapy failure and future direction in CAR\u2010T cell therapy for B\u2010ALL.<\/jats:p>","DOI":"10.1111\/ejh.14132","type":"journal-article","created":{"date-parts":[[2023,12,18]],"date-time":"2023-12-18T02:45:57Z","timestamp":1702867557000},"page":"51-63","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Determinants of outcomes and advances in <scp>CD19<\/scp>\u2010directed chimeric antigen receptor therapy for B\u2010cell acute lymphoblastic leukemia"],"prefix":"10.1111","volume":"112","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5144-3467","authenticated-orcid":false,"given":"Supriya","family":"Gupta","sequence":"first","affiliation":[{"name":"Division of Hematology Mayo Clinic  Rochester Minnesota 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