Li, QinRane, LalitPoiret, ThomasZou, JiezhiMagalhaes, IsabelleAhmed, RaijaDu, ZimingVudattu, NaliniMeng, QingdaGustafsson-Jernberg, ÅsaWiniarski, JacekRingdén, OlleMaeurer, MarkusRemberger, MatsErnberg, Ingemar2016-11-182016Li, Q., L. Rane, T. Poiret, J. Zou, I. Magalhaes, R. Ahmed, Z. Du, et al. 2016. “Both high and low levels of cellular Epstein-Barr virus DNA in blood identify failure after hematologic stem cell transplantation in conjunction with acute GVHD and type of conditioning.” Oncotarget 7 (21): 30230-30240. doi:10.18632/oncotarget.8803. http://dx.doi.org/10.18632/oncotarget.8803.1949-2553http://nrs.harvard.edu/urn-3:HUL.InstRepos:29408287The level of Epstein-Barr virus DNA in blood has proven to be a biomarker with some predictive value in allogeneic hematopoietic stem cell transplantation patients (HSCT). We evaluated the impact of EBV load on survival of 51 patients (32M/19F, median age: 32 years, from < 1 to 68 years old), who had received HSCT for different types of malignancies (49 cases) or non-malignancies (2 cases). The overall survival [1]was compared between patients with extreme and moderate cell bound EBV DNA levels. Different sources of stem-cells (peripheral blood stem, n = 39; bone marrow, n = 9; or umbilical cord blood, n = 3) were used. Twenty patients received reduced-intensity conditioning regimen while the other 31 received myeloablative conditioning. Patients with high or very low level of cell bound EBV-DNA levels had a shorter OS than those with moderate EBV load: OS at 5 years was 67% vs 90% (p < 0.03). There was a conspicuous relationship between EBV load and the reconstitution dynamics of total and EBV-specific T cells, CD4+ and CD4- CD8- (double negative) T cells in the few patients where it was analyzed. This was not statistically significant. Two other factors were associated to early mortality in addition to high or low EBV load: acute GVHD II-IV (p < 0.02) and pre-transplant conditioning with total body irradiation (TBI) ≥6 Gy, (p < 0.03). All the patients meeting all three criteria died within two years after transplantation. This points to a subgroup of HSCT patients which deserve special attention with improvement of future, personalized treatment.en-USstem cell transplantationEBV DNA-loadT-cell phenotypetotal body irradiationaGVHDImmunology and Microbiology SectionImmune responseImmunityJournal Article2016-11-1810.18632/oncotarget.8803