BETA - Are bone marrow transplants used to treat chronic lymphocytic leukemia?

Are bone marrow transplants used to treat chronic lymphocytic leukemia? Bone marrow transplant for CLL, that's a very interesting question and an evolving question. So over the last 10 years with the introduction of the targeted agents, BTK inhibitors and the BCL2 inhibitors, we saw major changes in how patients responded. The responses were durable. They were deep and durable. And we were kind of in this honeymoon phase for patients with CLL where they were having excellent responses. We had studies that showed survival outcomes which were better than prior treatments. But now those patients, so during that time we forgot about transplants, allogenic transplants. And nobody in the last 10 years have not referred patients for an allogenic transplant. But things have changed now. Now we have patients in the clinic who have received these targeted agents, some patients who have received the targeted agents, both lines of targeted agents, the BTK and the BCL2 inhibitors, and are now progressing. And they don't have reasonable options. We definitely had the non-covalent BTK inhibitor approved perturbed root nev. We have CAR therapy for them. But then if you look at the complete response rate with those drugs, those are very low. And we really don't know who the patients are who will respond to CAR therapy. CR rates are 20% and we don't know who those patients will be. So what we are seeing nowadays for these patients who are dual refractory or dual exposed, we are seeing that we are sending them more and more to transplant. Because transplant remains the only curable therapy for treatment of patients with CLL. But how those patients will respond, I'm not sure at this point. They're dual exposed, dual refractory. I think we need to collect more data on that to see the efficacy of transplant in those patients. But definitely, yes, I see myself sending more patients for transplant consults.