clinicaltrials.gov Identifier: NCT00459771.

Our data suggest that discontinuation of imatinib is safe in patients with durable MR(4.5).

BackgroundAlthough peer-to-peer contact might empower patients in various ways, studies show that only a few patients actually engage in support groups.ObjectiveThe objective of our study was to explore factors that facilitate or impede engagement in face-to-face and online peer support, using the Theory of Planned Behavior.MethodsA questionnaire was completed by 679 patients being treated for arthritis, breast cancer, or fibromyalgia at two Dutch regional hospitals.ResultsOur results showed that only a minority of the patients engaged in organized forms of peer support. In total 10% (65/679) of the respondents had engaged in face-to-face meetings for patients in the past year. Only 4% (30/679) of the respondents had contact with peers via the Internet in the past year. Patients were more positive about face-to-face peer support than about online peer support (P < .001). In accordance with the Theory of Planned Behavior, having a more positive attitude (P < .01) and feeling more supported by people in the social environment (P < .001) increased the intention to participate in both kinds of peer support. In addition, perceived behavioral control (P = .01) influenced the intention to participate in online peer support. Nevertheless, the intention to engage in face-to-face and online peer support was only modestly predicted by the Theory of Planned Behavior variables (R 2 = .33 for face-to-face contact and R 2 = .26 for online contact).ConclusionAlthough Health 2.0 Internet technology has significantly increased opportunities for having contact with fellow patients, only a minority seem to be interested in organized forms of peer contact (either online or face-to-face). Patients seem somewhat more positive about face-to-face contact than about online contact.

Adoptive immunotherapy with donor lymphocyte infusions (DLI) is an effective treatment for relapsed chronic myeloid leukemia (CML) after allogeneic stem cell transplantation. To identify the effector and target cell populations responsible for the elimination of the leukemic cells in vivo we developed an assay to measure the frequency of T lymphocyte precursor cells capable of suppressing leukemic progenitor cells. Target cells in this assay were CML cells that were cultured in the presence of stem cell factor, interleukin 3, granulocyte-macrophage colony-stimulating factor, granulocyte colony-stimulating factor, and erythropoietin.[ 3 H]thymidine incorporation at day 7 represented the proliferation of the progeny of the CD34 ؉ CML progenitor cells, and not of the more mature CD34 ؊ CML cells. Effector cells were mononuclear cells, which were used in a limiting dilution analysis to measure the frequencies of CML progenitor cellinhibitory lymphocyte precursors (PCILp) in peripheral blood of seven patients before and after DLI for relapsed CML. In the six patients who entered complete remission, a 5-to 100-fold increase of PCILp was found during the clinical response. In the patient with resistant relapse the frequency of PCILp was <10 per ml before and after DLI. Leukemiareactive helper T lymphocyte precursor frequencies remained unchanged after DLI. A significant increase in cytotoxic T lymphocyte precursor frequency against more mature leukemic cells was found in only two responding patients. These results indicate that T cells specifically directed against CD34 ؉ CML progenitor cells mediate the antileukemic effect of DLI.Allogeneic stem cell transplantation (SCT) is potentially curative in patients with chronic myeloid leukemia (CML) not only by the cytoreductive effects of irradiation and chemotherapy, but also by a graft-versus-leukemia effect (1). Clinical evidence for this effect by the immunocompetent cells in the stem cell graft is supported by a lower risk of relapse in patients with graft-versus-host disease (GvHD) after transplantation (2), and an increased risk of relapse in patients treated with a syngeneic transplant (3) or a T cell-depleted transplant (4-6). Moreover, the transfusion of lymphocytes from the original stem cell donor in patients with a cytogenetic or hematological relapse of CML after SCT results in a complete remission in 70-80% of the patients (7-12). The response rate is lower in patients with relapsed CML in accelerated phase or blast crisis (10, 12). DLI is accompanied by GvHD and bone marrow aplasia in 90% and 35-50% of the patients, respectively (10, 12).The frequency of allo-reactive T cells in an HLA-identical donor that may react with patient leukocytes or leukemic cells is low (13-15). The development of acute GvHD and bone marrow aplasia during the responsive phase after DLI was associated with increased patient-reactive helper T lymphocyte precursor (HTLp) frequencies, as determined in a limiting dilution assay using cocultures of peripheral blood MNC after DLI...

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