Other than fertility, are there any long-term effects of AML treatment that are specific to women?

Other than fertility, are there any long-term effects of AML treatment that are specific to women? I wouldn't say that it's specific. I think it's overall in general there are long-term issues with both men and women outside of the fertility things. We in the world of adult AML have not yet reached our goal of curing everybody with leukemia. So our bias is always to treat maximally in a way that improves the chances of cure. And sometimes that means that certain drugs are going to cause issues in the long term. We use drugs like anthracyclines that tend to have an effect on your heart function. So there is a slightly increased risk of heart failure down the line because these chemotherapy regimens can affect heart function. Post-transplant there is a whole, there's several complications that can happen in somebody who is post-transplant where there is slightly increased risk of cancer in general long term that is not leukemia. So once you survive leukemia there is slightly higher chance of getting other cancers down the line. And that's something we always monitor for in the future. Cardiovascular risk is something we care about in the long term as well because a lot of patients get treatments that can affect cardiac function and also there's like this field of we call it cardio-oncology where we see that these cardiac complications are higher in patients who have cancer. And there are several hypotheses of why that happens and that maybe independent of treatment is just a common sort of aging process that takes place when you get leukemia and cardiovascular illnesses. So the risk of cardiovascular disease is something we monitor very carefully in people who are long term survivors of the disease. And obviously the debility, I think that's a big one. After, especially after chemotherapy transplant patients can lose their physical strength, muscular strength. And it takes a while to get back to your normal state and that's especially if you have some long term complications or graft versus host disease from the transplant. All of this is going to affect their ability to function. And there's a whole psychological component to it that we underestimate in these patients because we care so much about curing them and then they go through this treatment process, finish everything and then you set them out back into their lives and saying, all right, you go back to your lives and it's difficult. It's actually difficult to invest so many years into your AML management and then go back to being quote unquote normal. But it is not normal. Your body has changed. Your outlook to life has changed. You may not get your job back. But they're going back to being functional and they want to work. There's a there's a men's psychological toll on patients when they go back to their real or not real but back to their so-called normal life. And it's important because believe me there's a huge when I at the end of five years we call it after five years that somebody is cured. And I tell patients, all right, you're done. You're five years. That's the time where they break down actually because they don't know how to go about back to when I say go back, you know, go go wherever. And it takes some time and we have to prepare them for it. You know, even meeting psychologists, family involvement, that it's going to take some time to transition back to life. It's very difficult for patients when we think where we are giving them their good news of everything is done, go back. They are the most unsure and insecure about going back to everything. And also there's this connection there where I say, OK, you don't need to see me anymore. And then they would say, well, but, you know, how do I know this is not going to come back? And it's a lot for a patient to handle. And we underestimate the psychological impact of this disease.