In relapsed/refractory B-ALL, treatment typically necessitates bispecific antibodies or CAR-T cell therapy; however, induction agents like vincristine and prednisone often down-regulate CD58 expression on tumor cells, consequently reducing the effectiveness of Blinatumomab and anti-CD19-CAR-T in B-ALL (12, 58, 59). The gene discussed is CD19; the disease is neoplasm.