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We retrospectively compared the main outcomes of an HLA matched or 1\u2010allele mismatched related or unrelated allo\u2010SCT in adult patients affected by acute leukemia (AL) or myelodysplastic syndromes (MDS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Fifty\u2010nine patients received cyclophosphamide (Cy)\u2010TBI (13.5\u2009Gy) and graft\u2010versus\u2010host disease (GVHD) prophylaxis with a calcineurin\u2010inhibitor plus methrotrexate (CyTBI group) and 28 patients received fludarabine\u2010TBI (8.8\u201313.5\u2009Gy) and GVHD prophylaxis with PTCy and tacrolimus (FluTBI\u2010PTCy group).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Median follow\u2010up for survivors was 82 and 22\u2009months. The 12\u2010month probability of overall survival and progression\u2010free survival were similar (<jats:italic>p\u2009=<\/jats:italic>\u2009.18, <jats:italic>p<\/jats:italic>\u2009=\u2009.7). The incidence of Grades 2\u20134 and 3\u20134 acute GVHD, and the incidence of moderate\u2010to\u2010severe chronic GVHD were higher in the CyTBI group (<jats:italic>p<\/jats:italic>\u2009=\u2009.02, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.01and <jats:italic>p<\/jats:italic>\u2009=\u2009.03). Nonrelapse mortality (NRM) at 12\u2009months posttransplant was higher in the CyTBI group (<jats:italic>p\u2009=<\/jats:italic>\u20090.05), while the incidence of relapse was similar in both groups (<jats:italic>p<\/jats:italic>\u2009=\u20090.7). The number of GVHD\u2010free and relapse\u2010free patients without systemic immunosuppression (GRFS) at 1\u2010year posttransplant was higher in the FluTBI\u2010PTCy group (<jats:italic>p<\/jats:italic>\u2009=\u20090.01).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The study confirms the safety and efficacy of a novel FluTBI\u2010PTCy platform with reduced incidence of severe acute and chronic GVHD, and early improvement of NRM.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ejh.13978","type":"journal-article","created":{"date-parts":[[2023,4,14]],"date-time":"2023-04-14T16:34:50Z","timestamp":1681490090000},"page":"146-153","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Sequence matters: Total body irradiation (TBI)\u2010based myeloablative conditioning with post\u2010transplant cyclophosphamide may reduce the early nonrelapse mortality compared with pretransplant cyclophosphamide plus <scp>TBI<\/scp>"],"prefix":"10.1111","volume":"111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8967-7410","authenticated-orcid":false,"given":"Sara","family":"Redondo","sequence":"first","affiliation":[{"name":"Hematology Department Hospital de la Sant Creu i Sant Pau, IIB\u2010Sant Pau and Jos\u00e9 Carreras Leukemia Research Institutes, Departamento de Medicina, Universidad Aut\u00f3noma de Barcelona  Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2994-9055","authenticated-orcid":false,"given":"Irene","family":"Garc\u00eda\u2010Cadenas","sequence":"additional","affiliation":[{"name":"Hematology Department Hospital de la Sant Creu i Sant Pau, IIB\u2010Sant Pau and Jos\u00e9 Carreras Leukemia Research Institutes, Departamento de Medicina, Universidad Aut\u00f3noma de Barcelona  Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio","family":"Vila","sequence":"additional","affiliation":[{"name":"Radiotherapy Oncology Department Hospital de la Sant Creu i Sant Pau  Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6062-5980","authenticated-orcid":false,"given":"Albert","family":"Esquirol","sequence":"additional","affiliation":[{"name":"Hematology Department Hospital de la Sant Creu i Sant Pau, IIB\u2010Sant Pau and Jos\u00e9 Carreras Leukemia Research Institutes, Departamento de Medicina, Universidad Aut\u00f3noma de Barcelona  Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. M.","family":"Portos","sequence":"additional","affiliation":[{"name":"Hematology Department Hospital de la Sant Creu i Sant Pau, IIB\u2010Sant Pau and Jos\u00e9 Carreras Leukemia Research Institutes, Departamento de Medicina, Universidad Aut\u00f3noma de Barcelona  Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8750-0195","authenticated-orcid":false,"given":"Silvana","family":"Novelli","sequence":"additional","affiliation":[{"name":"Hematology Department Hospital de la Sant Creu i Sant Pau, IIB\u2010Sant Pau and Jos\u00e9 Carreras Leukemia Research Institutes, Departamento de Medicina, Universidad Aut\u00f3noma de Barcelona  Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Silvana","family":"Saavedra","sequence":"additional","affiliation":[{"name":"Hematology Department Hospital de la Sant Creu i Sant Pau, IIB\u2010Sant Pau and Jos\u00e9 Carreras Leukemia Research Institutes, Departamento 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