As for antigen downregulation, that is one mechanism of resistance. Antigen loss (up to 30% of B-cell ALL patients who initially respond can relapse with a CD19 negative clone(s)), truncated protein, or downregulation, loss or mutation of CD58 are others https://www.jci.org/articles/view/159402
Long-term (assuming positive clinical data this year), want 19B to displace 2nd/3rd-line auto, but other companies are already working on ways to overcome those and other mechanisms of resistance. So, I think they should be doing the same, including creating an anti-CD19/CD20 CAR https://aacrjournals.org/cancerimmunolres/article/4/6/498/468518/T-Cells-Expressing-CD19-CD20-Bispecific-Chimeric https://ashpublications.org/blood/article/136/Supplement%201/53/470303/CD58-Aberrations-Limit-Durable-Responses-to-CD19 https://www.abstractsonline.com/pp8/#!/10828/presentation/3056
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