Why are bone marrow biopsies (BMB) used in myeloma and what tests are run on the BMB samples?

[Music] y're bone-marrow biopsy is necessary so until we find a better way to evaluate disease biology the bone marrow biopsies are going to be a very important part of you know your your journey in myeloma each time myeloma comes back the disease biology is different from before so it's important for us not just understand it we are starting to get to a place where we can tease out what therapies patients need for certain subsets so I think it's it's it's important myeloma is not one disease even within a given patient it's not the same you have many different clones of myeloma so as their disease evolves it's important to kind of keep a check on some of those things patients do pick up other abnormalities that they did not have at the time of diagnosis and we won't know about them unless we're doing a repeat biopsy what testing is done on the bone marrow biopsy sample most myeloma centers would be doing cytogenetics fish panels as a standard of care along with flow cytometry and then we look at certain markers on the bone marrow of Astrakhan biopsy and then we are doing gene mutation panels in the context of certain clinical trials or projects to tease out specific gene mutations that patients may have the big example that all of us are excited about is the my drug trial that's moving through the multiple myeloma Research Consortium where we are using those gene mutation panels to identify patients who have specific abnormalities and then give them the treatment that actually will will hopefully have an impact for that subset of disease on top of the standard of care so I think that that's that's where we we are going to head in treatment unless you're doing the biopsy we won't know