The goal of this observational study is to assess the clinical response and the effect ofautophagy function in patients before, during and throughout oral low dose sirolimus(rapamycin) therapy. The main questions this study aims to answer are: - Does rapamycin reduce the overall symptom burden in this patient population and does it improve the quality of life? - Does rapamycin change mTOR driven autophagy deficits observed in a subset of patients?Participants will be asked to complete a series of questionnaires and quality of lifeinstruments before starting rapamycin therapy prescribed by their physician andthroughout their course of treatment. Study blood samples will be collected beforestarting therapy and throughout the course of treatment to assess serological markers ofautophagy function.