Posttransplant high-dose cyclophosphamide (PTCy) effectively prevents GvHD after haploidentical SCT. However, its use in HLA-matched SCT has been less explored. Fifty-six consecutive patients who underwent allo-SCT for hematological malignancies have been included in this prospective single-center protocol. Donors have been HLA-identical siblings, fully-matched unrelated or 1-allele-mismatched unrelated donors in 30%, 32%, and 37% of cases, respectively. Nine patients have received a TBI-containing MAC regimen, while the remaining (84%) received RIC platforms based on Fludarabine plus Busulfan/Melphalan. Due to the high graft failure (GF) rate (21%) in a preliminary analysis in the allo-RIC cohort (n = 29), protocol amendments have been implemented, with no further cases of GF after the introduction of mini-thiotepa (0/18). The overall incidence of grade II–IV acute GvHD is 24% (95% CI: 17–31%) with four steroid-refractory cases. Severe chronic GvHD has occurred in only 1 of 43 evaluable cases. The 1-year NRM and relapse are 18% (95% CI: 12–26%) and 30% (18–42%) and the OS and DFS are 78% and 64%, respectively. These outcomes support the feasibility of using PTCy as a SOC outside the haplo-setting, albeit mini-thiotepa (3 mg/kg) was incorporated in the standard allo-RIC platforms to prevent GF. Despite the limitations of a single-center experience and the short follow-up, these protocols show promising results with particular benefit in reducing the occurrence of moderate-to-severe GvHD.

移植后大剂量环磷酰胺（PTCy）可有效预防单倍SCT后的GvHD。但是，它在HLA匹配SCT中的用途已很少探索。该前瞻性单中心研究方案包括了接受血液异种肿瘤异基因-SCT治疗的56例连续患者。供体是HLA相同的同胞，分别是30％，32％和37％的完全匹配的无关或1等位基因不匹配的无关供体。9名患者接受了含TBI的MAC方案，其余（84％）患者接受了以氟达拉滨加白消安/美法仑为基础的RIC平台。由于同种异体RIC队列（n = 29），已经实施了方案修正案，在引入小硫替比（0/18）之后不再有GF的病例。II级至IV级急性GvHD的总发病率为24％（95％CI：17-31％），其中有4例激素治疗难治性病例。在43例可评估病例中，只有1例发生了严重的慢性GvHD。一年的NRM和复发率分别为18％（95％CI：12–26％）和30％（18–42％），OS和DFS分别为78％和64％。这些结果支持将PTCy用作单倍型设定以外的SOC的可行性，尽管在标准的allo-RIC平台中加入了微型硫替泰（3 mg / kg）来预防GF。尽管单中心经验有限且随访时间短，但这些协议仍显示出令人鼓舞的结果，特别有利于减少中度至重度GvHD的发生。