If you relapse after an allo transplant would you get another? Is that when donor site infusions come in?

If you relapse after an allotransplant, would you get another? Is that when a donor lymphocyte infusion comes in? It depends on the transplantor. Like I've done many transplants where I've done them once or twice. It depends a little bit on trying to figure out why did the person relapse. And you might imagine, OK, if I get another transplant, should I get the same donor or should I use a different donor? And it depends on how you relapse. Sometimes it's better to use the same one and sometimes it's better to use a different one. It's not out of the realm of possibility. It's done in the minority of patients. You have to have done well with the first transplant. Like if we crushed you with the first transplant, you'd be crazy to even say you want a second transplant. So there are a lot of factors that go into it, but it's not something that I would say is off the table depending on where you go to do the transplant in the first place. If a patient relapses after transplant, another transplant usually ends up being the goal as long as we can get the patient back into remission with chemotherapy or other drugs to try and get a remission, including the use of a hypomethylating agent and vanetoclax. Stem cell lymphocyte infusions are when we take a special type of white blood cell called a lymphocyte from the stem cell donor and give it to the person who got the stem cell transplant to try and improve the efficacy of the bone marrow transplant if it looks like one is losing the transplant or one has relapsed, unfortunately.