My name is Rakesh Popat and I'm a Hematologist at University College of London in the UK. My first presentation here at the EHAR 2024 meeting was discussing about some of the practicalities of delivering bi-specific T cell antibodies for patients with relapsed multiple myeloma. What we know is that bi-specific antibodies are very effective for patients with relapsed multiple myeloma, but clinicians and hospitals as well as patients can face some real challenges in order to deliver this. So what we have to work out as a shared decision-making model between the healthcare professionals and the patients is what the best way to deliver this treatment is and indeed thinking about some of the more convenient aspects for it. What we know in terms of these treatments is that whilst they're very effective, their side effect profile can be significant in terms of causing what we call cytokine release syndrome where patients could get a fever, they might feel unwell or ICANS which is something where you can get headaches or maybe feel a bit drowsy. Now the reality is that whilst these things may sound a bit scary, they're actually very infrequent in terms of high severity. So what I'm saying is that whilst these events can occur, they're very manageable and they generally do not cause problems for our patients. Nevertheless what we're mandated to do is to keep the patient at least close to hospital that's in the Europe and in the UK and in the US you need to be able to hospitalise the patient during the initial dosing period. And so I shared a case of one of my patients who'd had five different rounds of treatment, the last round of treatment was Blantyma Baphidotin and then went on and received Elrondatinab. And when we gave Elrondatinab, and this is a BCMA bispecific antibody, the patient developed cytokine release syndrome after the first dose which was manifested by a fever but otherwise this patient was actually very well. However, because the fever persisted for about 18 hours, we gave a drug called Tosolizumab which calmed the whole immune system down and the patient was fine. We then continued to dose the patient and then she developed an upper respiratory tract infection which we had to treat and so we had to interrupt the next drug. Finally we managed to treat the patient and let her out and she did really well, she achieved a complete remission but unfortunately she developed a severe infection which led her to come into hospital giving intravenous antibiotics. At that point we gave her intravenous immunoglobulin or IVIG which is to supplement her immune system and from there onwards she actually had no further infections and had an excellent response. So these kind of, I think this case illustrates all the different areas and aspects that we need to think about very carefully when delivering this very high effective treatment for patients with relapsed myeloma.