同种异体造血干细胞移植（alloHSCT）是治疗急性白血病和许多其他血液恶性肿瘤的标准治疗方法。适用于不同类型移植的免疫抑制剂的正确选择仍需要严格和谨慎的考虑，而在这方面的数据却相互矛盾。因此，在这项单中心的回顾性研究中，我们旨在比较145名接受免疫不配合兄弟或半相合同胞移植（MMUD和haplo-HSCT）后环磷酰胺（PTCy）治疗或仅接受GvHD预防治疗的患者的结果。我们尝试验证PTCy是否是MMUD设置中的最佳策略。93名受试者（93/145；64.1％）接受了haplo-HSCT，而52名（52/145；35.9％）接受了MMUD-HSCT。共有110名患者接受了PTCy（93名在haplo组和17名在MMUD组），而35名患者仅在MMUD组中接受了基于抗胸腺细胞球蛋白（ATG）、环孢素A（CsA）和甲氨蝶呤（Mtx）的传统GvHD预防治疗。我们的研究发现，接受PTCy治疗的患者表现出降低的急性GvHD发病率和CMV再激活率，以及在抗病毒治疗前后的CMV拷贝数统计上，与CsA + Mtx + ATG组相比具有更低的拷贝数。考虑到慢性GvHD，主要预测因素是供体年龄≥40岁，并且接受haplo-HSCT治疗。此外，接受PTCy治疗的MMUD-HSCT患者的生存率比接受CsA + Mtx + ATG治疗的患者高8倍以上（OR = 8.31，p = 0.003）。这些数据一起表明，无论是哪种类型的移植，使用PTCy都比ATG更有益于生存率。然而，需要进行更大样本的研究来确认文献研究中的矛盾结果。

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, ≥40 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.