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However, the clinical characteristics and outcomes of EBV-viral load are not well known. Thus, we retrospectively analyzed the clinical features and prognostic impact of the EBV viral load in 121 allo-HSCT recipients from our hospital. EBV DNA quantification was performed in whole blood after transplantation. Patients were grouped based on whether EBV DNA quantification reached\u2009&gt;\u20091000 copies\/mL during follow-up (<jats:italic>N<\/jats:italic>\u2009=\u200950) or not (<jats:italic>N<\/jats:italic>\u2009=\u200971). Patients with EBV\u2009&gt;\u20091000 EBV copies\/mL were relatively more common in the groups with graft versus host disease (GVHD) prophylaxis including ATG, haploidentical donor type, peripheral blood as a donor source, and acute GVHD II\u2013IV. The 20-month OS and DFS were not significantly different between patients with\u2009&lt;\u20091000 EBV copies\/mL and patients with\u2009&gt;\u20091000 EBV copies\/mL (20-month OS, 56.0% vs. 60.6%; <jats:italic>p<\/jats:italic>\u2009=\u20090.503, 20-month DFS, 50.0% vs. 57.7%; <jats:italic>p<\/jats:italic>\u2009=\u20090.179). Immunosuppressant (ISS) dose reduction was achieved after the maximum increase in EBV in 41\/50 (82%) patients. Additionally, 30\/50 (60%) patients achieved a 50% dose reduction or no restarting of ISS within 3\u00a0months of the maximum EBV increase. Among cases wherein EBV DNA quantification reached\u2009&gt;\u20091000 copies\/mL, those that achieved rapid dose reduction of ISS tended to have longer overall survival (\u201cnot reached\u201d vs 5.4\u00a0months, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and disease-free survival (88.4\u00a0months vs 5.3\u00a0months, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) than those in patients who did not. Our data highlight the importance of rapid ISS reduction in post-transplant EBV reactivation.<\/jats:p>","DOI":"10.1007\/s00277-023-05596-6","type":"journal-article","created":{"date-parts":[[2023,12,29]],"date-time":"2023-12-29T08:02:58Z","timestamp":1703836978000},"page":"935-946","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Clinical characteristics and outcomes of Epstein-Barr virus viral load after allogeneic hematopoietic stem cell transplantation"],"prefix":"10.1007","volume":"103","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4776-4249","authenticated-orcid":false,"given":"Takafumi","family":"Tsushima","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shin-Ichi","family":"Masuda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natsumi","family":"Yoda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sayaka","family":"Kainuma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiharu","family":"Kimeda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiho","family":"Konno","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazusuke","family":"Tanaka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kosuke","family":"Matsuo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonoko","family":"Shimoji","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenji","family":"Kimura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hironori","family":"Arai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshikazu","family":"Utsu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ken-Ichi","family":"Imadome","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobuyuki","family":"Aotsuka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,12,29]]},"reference":[{"key":"5596_CR1","doi-asserted-by":"publisher","first-page":"84","DOI":"10.1016\/j.jcv.2018.03.001","volume":"102","author":"SK Dunmire","year":"2018","unstructured":"Dunmire SK, Verghese PS, Balfour HH Jr (2018) Primary Epstein-Barr virus infection. 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