Gaipa et al. described the down-modulation of CD58 expression on day 33 of treatment in patients with ALL, and these changes were considered to be prognostically significant.8 Our results and the data from Gaipa’s study suggest that it may be useful to avoid daunorubicin, prednisolone or vincristine immediately before specific anti-CD19 therapy as well as for bridging therapy to prevent CD58 down-modulation and a possible decrease in treatment efficacy. This evidence concerns the gene CD19 and acute lymphoblastic leukemia.