{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,28]],"date-time":"2026-02-28T07:59:25Z","timestamp":1772265565271,"version":"3.50.1"},"reference-count":44,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2023,3,17]],"date-time":"2023-03-17T00:00:00Z","timestamp":1679011200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Allogeneic hematopoietic cell transplantation (alloHSCT) is a standard therapeutic approach for acute leukemias and many other hematologic malignancies. The proper choice of immunosuppressants applicable to different types of transplantations still requires strict and careful consideration, and data in this regard are divergent. For this reason, in this single-centered, retrospective study, we aimed to compare the outcome of 145 patients who received post-transplant cyclophosphamide (PTCy) for MMUD and haplo-HSCT or GvHD prophylaxis for MMUD-HSCT alone. We attempted to verify if PTCy is an optimal strategy in MMUD setting. Ninety-three recipients (93\/145; 64.1%) underwent haplo-HSCT while 52 (52\/145; 35.9%) underwent MMUD-HSCT. There were 110 patients who received PTCy (93 in haplo and 17 in MMUD group) and 35 patients received conventional GvHD prophylaxis based on antithymocyte globulin (ATG), cyclosporine (CsA), and methotrexate (Mtx) in the MMUD group only. Our study revealed that patients receiving post-transplant cyclophosphamide (PTCy) show decreased acute GvHD rates and CMV reactivation as well as a statistically lower number of CMV copies before and after antiviral treatment compared to the CsA + Mtx + ATG group. Taking into account chronic GvHD, the main predictors are donor age, \u226540 years, and haplo-HSCT administration. Furthermore, the survival rate of patients following MMUD-HSCT and receiving PTCy with tacrolimus and mycophenolate mofetil was more than eight times greater in comparison to patients receiving CsA + Mtx + ATG (OR = 8.31, p = 0.003). These data taken together suggest that the use of PTCy displays more benefits in terms of survival rate compared to ATG regardless of the type of transplantation performed. Nevertheless, more studies with a larger sample size are required to confirm the conflicting results in the literature studies.<\/jats:p>","DOI":"10.3390\/ijms24065764","type":"journal-article","created":{"date-parts":[[2023,3,20]],"date-time":"2023-03-20T04:33:31Z","timestamp":1679286811000},"page":"5764","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["The Benefits of the Post-Transplant Cyclophosphamide in Both Haploidentical and Mismatched Unrelated Donor Setting in Allogeneic Stem Cells Transplantation"],"prefix":"10.3390","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3555-2887","authenticated-orcid":false,"given":"Jaros\u0142aw","family":"Dybko","sequence":"first","affiliation":[{"name":"Department of Hematology and Cellular Transplantation, Lower Silesian Oncology Center, 53-413 Wroclaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2007-7609","authenticated-orcid":false,"given":"Ma\u0142gorzata","family":"Sobczyk-Kruszelnicka","sequence":"additional","affiliation":[{"name":"Department of Bone Marrow Transplantation and Oncohematology, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, 44-102 Gliwice, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9904-1181","authenticated-orcid":false,"given":"Sebastian","family":"Makuch","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Pathology, Wroclaw Medical University, 50-368 Wroc\u0142aw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1118-5090","authenticated-orcid":false,"given":"Siddarth","family":"Agrawal","sequence":"additional","affiliation":[{"name":"Department and Clinic of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, 50-556 Wroc\u0142aw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Krzysztof","family":"Dudek","sequence":"additional","affiliation":[{"name":"Statistical Analysis Center, Wroclaw Medical University, 50-368 Wroclaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sebatian","family":"Giebel","sequence":"additional","affiliation":[{"name":"Department of Bone Marrow Transplantation and Oncohematology, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, 44-102 Gliwice, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lidia","family":"Gil","sequence":"additional","affiliation":[{"name":"Department of Hematology and Bone Marrow Transplantation, Poznan University of Medical Sciences, 60-569 Pozna\u0144, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,3,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1971","DOI":"10.1200\/JCO.20.03502","article-title":"National Marrow Donor Program\u2013Sponsored Multicenter, Phase II Trial of HLA-Mismatched Unrelated Donor Bone Marrow Transplantation Using Post-Transplant Cyclophosphamide","volume":"39","author":"Shaw","year":"2021","journal-title":"J. Clin. Oncol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"760","DOI":"10.1016\/j.jtct.2021.06.018","article-title":"Post-transplant Cyclophosphamide Versus Thymoglobulin in HLA-Mismatched Unrelated Donor Transplant for Acute Myelogenous Leukemia and Myelodysplastic Syndrome","volume":"27","author":"Modi","year":"2021","journal-title":"Transplant. Cell. Ther."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1056\/NEJMsa1311707","article-title":"HLA Match Likelihoods for Hematopoietic Stem-Cell Grafts in the U.S. Registry","volume":"371","author":"Gragert","year":"2014","journal-title":"N. Engl. J. Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1182\/blood-2021-151197","article-title":"Haploidentical Vs. Matched Unrelated Donor Transplants Using Post-Transplant Cyclophosphamide for Lymphoma: A Joint CIBMTR\/EBMT Study","volume":"138","author":"Mussetti","year":"2021","journal-title":"Blood"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1002\/ajh.25993","article-title":"Haploidentical vs matched unrelated donor transplantation for acute myeloid leukemia in remission: A prospective comparative study","volume":"96","author":"Cho","year":"2021","journal-title":"Am. J. Hematol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"811","DOI":"10.1038\/bmt.2017.34","article-title":"Use of haploidentical stem cell transplantation continues to increase: The 2015 European Society for Blood and Marrow Transplant activity survey report","volume":"52","author":"Passweg","year":"2017","journal-title":"Bone Marrow Transplant."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"562","DOI":"10.1038\/s41409-022-01577-x","article-title":"Post-transplant cyclophosphamide in one-antigen mismatched unrelated donor transplantation versus haploidentical transplantation in acute myeloid leukemia: A study from the Acute Leukemia Working Party of the EBMT","volume":"57","author":"Battipaglia","year":"2022","journal-title":"Bone Marrow Transplant."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"282","DOI":"10.1182\/blood-2011-03-344853","article-title":"Alternative donor transplantation after reduced intensity conditioning: Results of parallel phase 2 trials using partially HLA-mismatched related bone marrow or unrelated double umbilical cord blood grafts","volume":"118","author":"Brunstein","year":"2011","journal-title":"Blood"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"641","DOI":"10.1016\/j.bbmt.2008.03.005","article-title":"HLA-Haploidentical Bone Marrow Transplantation for Hematologic Malignancies Using Nonmyeloablative Conditioning and High-Dose, Posttransplantation Cyclophosphamide","volume":"14","author":"Luznik","year":"2008","journal-title":"Biol. Blood Marrow Transplant."},{"key":"ref_10","first-page":"e1","article-title":"Haploidentical versus Matched Unrelated versus Matched Sibling Donor Hematopoietic Cell Transplantation with Post-Transplantation Cyclophosphamide","volume":"28","author":"Mehta","year":"2022","journal-title":"Transplant. Cell. Ther."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"3316","DOI":"10.1002\/cncr.30180","article-title":"Results of a 2-arm, phase 2 clinical trial using post-transplantation cyclophosphamide for the prevention of graft-versus-host disease in haploidentical donor and mismatched unrelated donor hematopoietic stem cell transplantation","volume":"122","author":"Gaballa","year":"2016","journal-title":"Cancer"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"454","DOI":"10.1016\/j.bbmt.2009.01.002","article-title":"HLA-Mismatched Unrelated Donors as an Alternative Graft Source for Allogeneic Stem Cell Transplantation after Antithymocyte Globulin-Containing Conditioning Regimen","volume":"15","author":"Zabelina","year":"2009","journal-title":"Biol. Blood Marrow Transplant."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1002\/ajh.23592","article-title":"A conditioning platform based on fludarabine, busulfan, and 2 days of rabbit antithymocyte globulin results in promising results in patients undergoing allogeneic transplantation from both matched and mismatched unrelated donor","volume":"89","author":"Devillier","year":"2014","journal-title":"Am. J. Hematol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1047","DOI":"10.1016\/j.exphem.2008.03.011","article-title":"Anti-thymocyte globulin overcomes the negative impact of HLA mismatching in transplantation from unrelated donors","volume":"36","author":"Ayuk","year":"2008","journal-title":"Exp. Hematol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"855","DOI":"10.1016\/S1470-2045(09)70225-6","article-title":"Standard graft-versus-host disease prophylaxis with or without anti-T-cell globulin in haematopoietic cell transplantation from matched unrelated donors: A randomised, open-label, multicentre phase 3 trial","volume":"10","author":"Finke","year":"2009","journal-title":"Lancet Oncol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1502","DOI":"10.1182\/blood-2015-10-672071","article-title":"Posttransplantation cyclophosphamide for prevention of graft-versus-host disease after HLA-matched mobilized blood cell transplantation","volume":"127","author":"Mielcarek","year":"2016","journal-title":"Blood"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"3224","DOI":"10.1182\/blood-2009-11-251595","article-title":"High-dose cyclophosphamide as single-agent, short-course prophylaxis of graft-versus-host disease","volume":"115","author":"Luznik","year":"2010","journal-title":"Blood"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"288","DOI":"10.1182\/bloodadvances.2016002766","article-title":"Prospective study of nonmyeloablative, HLA-mismatched unrelated BMT with high-dose posttransplantation cyclophosphamide","volume":"1","author":"Kasamon","year":"2017","journal-title":"Blood Adv."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1196","DOI":"10.1016\/j.bbmt.2018.01.021","article-title":"Single Antigen\u2013Mismatched Unrelated Hematopoietic Stem Cell Transplantation Using High-Dose Post-Transplantation Cyclophosphamide Is a SuiTable Alternative for Patients Lacking HLA-Matched Donors","volume":"24","author":"Jorge","year":"2018","journal-title":"Biol. Blood Marrow Transplant."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"444","DOI":"10.1111\/bjh.13977","article-title":"Post-transplantation cyclophosphamide versus conventional graft-versus-host disease prophylaxis in mismatched unrelated donor haematopoietic cell transplantation","volume":"173","author":"Mehta","year":"2016","journal-title":"Br. J. Haematol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1016\/0198-8859(90)90071-V","article-title":"Effect of HLA incompatibility on graft-versus-host disease, relapse, and survival after marrow transplantation for patients with leukemia or lymphoma","volume":"29","author":"Anasetti","year":"1990","journal-title":"Hum. Immunol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"2976","DOI":"10.1182\/blood-2004-04-1674","article-title":"Limits of HLA mismatching in unrelated hematopoietic cell transplantation","volume":"104","author":"Petersdorf","year":"2004","journal-title":"Blood"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"885","DOI":"10.1016\/j.bbmt.2010.09.012","article-title":"HLA-C Antigen Mismatch Is Associated with Worse Outcome in Unrelated Donor Peripheral Blood Stem Cell Transplantation","volume":"17","author":"Woolfrey","year":"2011","journal-title":"Biol. Blood Marrow Transplant."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1080\/17474086.2019.1562331","article-title":"Hematopoietic stem cell transplant with HLA-mismatched grafts: Impact of donor, source, conditioning, and graft versus host disease prophylaxis","volume":"12","author":"Metheny","year":"2019","journal-title":"Expert Rev. Hematol."},{"key":"ref_25","first-page":"459","article-title":"Post-transplant cyclophosphamide and tacrolimus-mycophenolate mofetil combina- tion prevents graft-versus-host disease in allo- geneic peripheral blood hematopoietic cell transplantation from HLA-matched donors","volume":"23","author":"Caravelli","year":"2021","journal-title":"Biol Blood Marrow Transpl."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1186\/s13045-018-0586-4","article-title":"Post-transplant cyclophosphamide for graft-versus-host disease prophylaxis in HLA matched sibling or matched unrelated donor transplant for patients with acute leukemia, on behalf of ALWP-EBMT","volume":"11","author":"Ruggeri","year":"2018","journal-title":"J. Hematol. Oncol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1802","DOI":"10.1182\/blood.2019001323","article-title":"How we perform haploidentical stem cell transplantation with posttransplant cyclophosphamide","volume":"134","author":"McCurdy","year":"2019","journal-title":"Blood"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1017.e1","DOI":"10.1016\/j.jtct.2021.09.006","article-title":"Lower Incidence of Cytomegalovirus Reactivation Following Post-Transplantation Cyclophosphamide HLA-Mismatched Unrelated Donor Transplantation","volume":"27","author":"Camargo","year":"2021","journal-title":"Transplant. Cell. Ther."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"3291","DOI":"10.1182\/blood.2020009362","article-title":"Posttransplant cyclophosphamide is associated with increased cytomegalovirus infection: A CIBMTR analysis","volume":"137","author":"Goldsmith","year":"2021","journal-title":"Blood"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"2650","DOI":"10.1182\/bloodadvances.2021004192","article-title":"Posttransplant cyclophosphamide as GVHD prophylaxis for peripheral blood stem cell HLA-mismatched unrelated donor transplant","volume":"5","author":"Tsai","year":"2021","journal-title":"Blood Adv."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"S276","DOI":"10.1016\/j.bbmt.2016.12.183","article-title":"Cytomegalovirus Reactivation after Allogeneic Hematopoietic Stem Cell Transplantation with Post-Transplant Cyclophosphamide","volume":"23","author":"Hebert","year":"2017","journal-title":"Biol. Blood Marrow Transplant."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"857","DOI":"10.3324\/haematol.2020.271445","article-title":"Comparison of immune reconstitution between anti-T-lymphocyte globulin and posttransplant cyclophosphamide as acute graft-versus-host disease prophylaxis in allogeneic myeloablative peripheral blood stem cell transplantation","volume":"107","author":"Massoud","year":"2022","journal-title":"Haematologica"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"2008","DOI":"10.1016\/j.bbmt.2015.07.019","article-title":"Cytomegalovirus Reactivation after Allogeneic Hematopoietic Stem Cell Transplantation is Associated with a Reduced Risk of Relapse in Patients with Acute Myeloid Leukemia Who Survived to Day 100 after Transplantation: The Japan Society for Hematopoietic Cell Transplantation Transplantation-related Complication Working Group","volume":"21","author":"Takenaka","year":"2015","journal-title":"Biol. Blood Marrow Transplant."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"2003","DOI":"10.1182\/blood-2003-10-3616","article-title":"The impact of cytomegalovirus serostatus of donor and recipient before hematopoietic stem cell transplantation in the era of antiviral prophylaxis and preemptive therapy","volume":"103","author":"Boeckh","year":"2004","journal-title":"Blood"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1016\/S1083-8791(03)00287-8","article-title":"Cytomegalovirus in hematopoietic stem cell transplant recipients: Current status, known challenges, and future strategies","volume":"9","author":"Boeckh","year":"2003","journal-title":"Biol. Blood Marrow Transplant."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"2446","DOI":"10.1200\/JCO.1999.17.8.2446","article-title":"Analysis of factors that correlate with mucositis in recipients of autologous and allogeneic stem-cell transplants","volume":"17","author":"Rapoport","year":"1999","journal-title":"J. Clin. Oncol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"3204","DOI":"10.1182\/blood.V90.8.3204","article-title":"Total body irradiation and acute graft-versus-host disease: The role of gastrointestinal damage and inflammatory cytokines","volume":"90","author":"Hill","year":"1997","journal-title":"Blood"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"2754","DOI":"10.1182\/blood.V95.9.2754.009k25_2754_2759","article-title":"The primacy of the gastrointestinal tract as a target organ of acute graft-versus-host disease: Rationale for the use of cytokine shields in allogeneic bone marrow transplantation","volume":"95","author":"Hill","year":"2000","journal-title":"Blood"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"5311","DOI":"10.1182\/bloodadvances.2020003110","article-title":"Class II HLA mismatch improves outcomes following haploidentical transplantation with posttransplant cyclophosphamide","volume":"4","author":"Solomon","year":"2020","journal-title":"Blood Adv."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1628","DOI":"10.1016\/j.bbmt.2009.07.004","article-title":"Defining the Intensity of Conditioning Regimens: Working Definitions","volume":"15","author":"Bacigalupo","year":"2009","journal-title":"Biol. Blood Marrow Transplant."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1097\/00007890-197410000-00001","article-title":"Clinical manifestations of graft-versus-host disease in human recipients of marrow from hl-a-matched sibling donors1","volume":"18","author":"Glucksberg","year":"1974","journal-title":"Transplantation"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1016\/j.bbmt.2015.09.001","article-title":"International, Multicenter Standardization of Acute Graft-versus-Host Disease Clinical Data Collection: A Report from the Mount Sinai Acute GVHD International Consortium","volume":"22","author":"Harris","year":"2016","journal-title":"Biol. Blood Marrow Transplant."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1016\/j.bbmt.2014.12.001","article-title":"National Institutes of Health Consensus Development Project on Criteria for Clinical Trials in Chronic Graft-versus-Host Disease: I. The 2014 Diagnosis and Staging Working Group Report","volume":"21","author":"Jagasia","year":"2015","journal-title":"Biol. Blood Marrow Transplant."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"2912","DOI":"10.1182\/blood-2005-05-2004","article-title":"Hematopoietic cell transplantation (HCT)-specific comorbidity index: A new tool for risk assessment before allogeneic HCT","volume":"106","author":"Sorror","year":"2005","journal-title":"Blood"}],"container-title":["International Journal of Molecular Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1422-0067\/24\/6\/5764\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T18:57:42Z","timestamp":1760122662000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1422-0067\/24\/6\/5764"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3,17]]},"references-count":44,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2023,3]]}},"alternative-id":["ijms24065764"],"URL":"https:\/\/doi.org\/10.3390\/ijms24065764","relation":{},"ISSN":["1422-0067"],"issn-type":[{"value":"1422-0067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,3,17]]}}}