Birgitta Versluijs

52 Results the median of day 116) had a slightly greater likelihood of developing allo-LS than those who became RV-positive after day 116 (HR, 2.10; 95% CI, 0.89-5.00 P = .089). Univariate analysis of the influence of HSCT associated complications on allo-LS sho- wed that adenovirus reactivation (OR, 3.86; 95% CI, 1.56-9.5; P = .004) was predictive of allo-LS. aGVHD grade II-IV in other organs appeared to be a negative predictor (OR, 0.22; 95% CI, 0.061-0.78; P 5 .02). In multivariate analysis, only aGVHD remained a strong predictor for preventing allo-LS (OR, 0.1; 95% CI, 0.02-0.47; P = .004). The influence of aGVHD on the development of allo-LS for the whole group and for the RV-positive patients is shown in Figure 1B and C. In this study, aGVHD clearly develo- ped before the onset of allo-LS. The mean time to onset was 4 weeks for GVHD (range, 2-15 weeks) and 8 weeks for allo-LS (range, 2-26 weeks). In particular, in the RV-positive group, aGVHD grade II-IV in another organ was strongly protective against the develop- ment of allo-LS. We found no influence of the different individual viral species, or of the presence of a single virus or multiple viruses, on the development of allo-LS (data not shown). All patients who developed allo-LS were treated according to the protocol with MP pulse therapy, as discussed earlier. All patients demonstrated prompt initial improvement of clinical symptoms. Secondary endpoints OS was 72% (80/110) after a median follow up of 66 weeks (range, 4-230 weeks). Cau- se of death was relapse in 9 patients (8.2%) and nonrelapse mortality in 21 patients (19.1%). Fourteen of the 30 patients with allo-LS died (47%), all from transplantation- related causes: 3 from refractory aGVHD, 2 from invasive fungal infection, 1 from adeno- virus disease, 2 from sudden cardiac death of unknown cause, and 6 from ongoing lung disease. Univariate analysis identified adenovirus reactivation (OR, 0.28; 95% CI, 0.08- 0.96; P = .043) and the development of allo-LS (OR, 0.25; 95% CI, 0.10-0.61; P = .003) as predictors for lower survival. Relapse had no significant influence on OS (HR, 1.89; 95% CI, 0.246-14.59; P = .54). In multivariate analysis, only allo-LS remained a predictor in this cohort (OR, 0.29; 95% CI, 0.09-0.94; P = .04). The impact of allo-LS on OS is depicted in Figure 1D. 3