Purpose: Hematopoietic stem cell transplantation (HSCT) has been an important method of treatment in the advance of pediatric acute lymphoblastic leukemia (ALL). The indications for HSCT are evolving and require updated establishment. In this study, we aimed to investigate the efficacy of HSCT on the treatment outcome of pediatric ALL, considering the indications for HSCT and subgroups. Materials and Methods: A retrospective analysis was conducted on ALL patients diagnosed and treated at a single center. Risk groups were categorized based on age at diagnosis, initial white blood cell count, disease lineage (B/T), and cytogenetic study results. Data on the patients’ disease status at HSCT and indications of HSCT were collected. Indications for HSCT were categorized as upfront HSCT at 1st complete remission, relapse, and refractory disease. Results: Among the 549 screened patients, a total of 418 patients were included in the study; B-cell ALL (n=379) and T-cell ALL (T-ALL) (n=39). HSCT was conducted on a total of 106 patients (25.4%), with a higher frequency as upfront HSCT in higher-risk groups and specific cytogenetics. The overall survival (OS) was significantly better when done upfront than in relapsed or refractory state in T-ALL patients (p=0.002). The KMT2A-rearranged ALL patients showed superior event-free survival (p=0.002) and OS (p=0.022) when HSCT was done as upfront treatment. Conclusion HSCT had a substantial positive effect in a specific subset of pediatric ALL. In particular, frontline HSCT for T-ALL and KMT2A-rearranged ALL offered a better prognosis than when HSCT was conducted in a relapsed or refractory setting.

Purpose: Hematopoietic stem cell transplantation (HSCT) has been an important method of treatment in the advance of pediatric acute lymphoblastic leukemia (ALL). The indications for HSCT are evolving and require updated establishment. In this study, we aimed to investigate the efficacy of HSCT on the treatment outcome of pediatric ALL, considering the indications for HSCT and subgroups. Materials and Methods: A retrospective analysis was conducted on ALL patients diagnosed and treated at a single center. Risk groups were categorized based on age at diagnosis, initial white blood cell count, disease lineage (B/T), and cytogenetic study results. Data on the patients’ disease status at HSCT and indications of HSCT were collected. Indications for HSCT were categorized as upfront HSCT at 1st complete remission, relapse, and refractory disease. Results: Among the 549 screened patients, a total of 418 patients were included in the study; B-cell ALL (n=379) and T-cell ALL (T-ALL) (n=39). HSCT was conducted on a total of 106 patients (25.4%), with a higher frequency as upfront HSCT in higher-risk groups and specific cytogenetics. The overall survival (OS) was significantly better when done upfront than in relapsed or refractory state in T-ALL patients (p=0.002). The KMT2A-rearranged ALL patients showed superior event-free survival (p=0.002) and OS (p=0.022) when HSCT was done as upfront treatment. Conclusion HSCT had a substantial positive effect in a specific subset of pediatric ALL. In particular, frontline HSCT for T-ALL and KMT2A-rearranged ALL offered a better prognosis than when HSCT was conducted in a relapsed or refractory setting.

Purpose: Hematopoietic stem cell transplantation (HSCT) has been an important method of treatment in the advance of pediatric acute lymphoblastic leukemia (ALL). The indications for HSCT are evolving and require updated establishment. In this study, we aimed to investigate the efficacy of HSCT on the treatment outcome of pediatric ALL, considering the indications for HSCT and subgroups. Materials and Methods: A retrospective analysis was conducted on ALL patients diagnosed and treated at a single center. Risk groups were categorized based on age at diagnosis, initial white blood cell count, disease lineage (B/T), and cytogenetic study results. Data on the patients’ disease status at HSCT and indications of HSCT were collected. Indications for HSCT were categorized as upfront HSCT at 1st complete remission, relapse, and refractory disease. Results: Among the 549 screened patients, a total of 418 patients were included in the study; B-cell ALL (n=379) and T-cell ALL (T-ALL) (n=39). HSCT was conducted on a total of 106 patients (25.4%), with a higher frequency as upfront HSCT in higher-risk groups and specific cytogenetics. The overall survival (OS) was significantly better when done upfront than in relapsed or refractory state in T-ALL patients (p=0.002). The KMT2A-rearranged ALL patients showed superior event-free survival (p=0.002) and OS (p=0.022) when HSCT was done as upfront treatment. Conclusion HSCT had a substantial positive effect in a specific subset of pediatric ALL. In particular, frontline HSCT for T-ALL and KMT2A-rearranged ALL offered a better prognosis than when HSCT was conducted in a relapsed or refractory setting.

Purpose: An endoscopic subureteral injection (EI) using a bulking agent is a highly successful surgical procedure, particularly for low-grade vesicoureteral reflux (VUR). Despite the serious adverse effects, routine voiding cystourethrogram (VCUG) to determine radiographic success after EI remains controversial. This study evaluated the necessity of routine postoperative VCUG in children with primary low-grade VUR. Materials and Methods: From January 2016 to August 2021, children who underwent EI for primary low-grade (I-III) VUR with a history of febrile urinary tract infection (fUTI) were analyzed retrospectively. From January 2016 to July 2018, routine VCUG following EI was performed on all children. Thereafter, postoperative VCUG was performed only if indicated. Clinical success was defined as no fUTI during a 12-month follow-up, and radiographic success was defined as the disappearance of VUR on postoperative VCUG. The clinical and radiographic outcomes in both groups were compared. Results: Thirty-six children were analyzed in this study. Three children (8.3%) experienced postoperative fUTI. In the routine group, clinical and radiographic success was observed in 16/17 (94.1%) and 15/17 (88.2%), respectively. Two children in the routine group experienced radiographic failure. Among these, one child showed clinical success, and the other underwent additional EI due to clinical failure. Of the indicated group, clinical failure was observed in 2/19 (10.5%). Of them, persistent VUR was identified in one child. Conclusions Clinical and radiologic success after EI for primary low-grade VUR is high, and routine VCUG for confirming radiographic success has a limited impact on the clinical course.

Purpose: An endoscopic subureteral injection (EI) using a bulking agent is a highly successful surgical procedure, particularly for low-grade vesicoureteral reflux (VUR). Despite the serious adverse effects, routine voiding cystourethrogram (VCUG) to determine radiographic success after EI remains controversial. This study evaluated the necessity of routine postoperative VCUG in children with primary low-grade VUR. Materials and Methods: From January 2016 to August 2021, children who underwent EI for primary low-grade (I-III) VUR with a history of febrile urinary tract infection (fUTI) were analyzed retrospectively. From January 2016 to July 2018, routine VCUG following EI was performed on all children. Thereafter, postoperative VCUG was performed only if indicated. Clinical success was defined as no fUTI during a 12-month follow-up, and radiographic success was defined as the disappearance of VUR on postoperative VCUG. The clinical and radiographic outcomes in both groups were compared. Results: Thirty-six children were analyzed in this study. Three children (8.3%) experienced postoperative fUTI. In the routine group, clinical and radiographic success was observed in 16/17 (94.1%) and 15/17 (88.2%), respectively. Two children in the routine group experienced radiographic failure. Among these, one child showed clinical success, and the other underwent additional EI due to clinical failure. Of the indicated group, clinical failure was observed in 2/19 (10.5%). Of them, persistent VUR was identified in one child. Conclusions Clinical and radiologic success after EI for primary low-grade VUR is high, and routine VCUG for confirming radiographic success has a limited impact on the clinical course.

Purpose: An endoscopic subureteral injection (EI) using a bulking agent is a highly successful surgical procedure, particularly for low-grade vesicoureteral reflux (VUR). Despite the serious adverse effects, routine voiding cystourethrogram (VCUG) to determine radiographic success after EI remains controversial. This study evaluated the necessity of routine postoperative VCUG in children with primary low-grade VUR. Materials and Methods: From January 2016 to August 2021, children who underwent EI for primary low-grade (I-III) VUR with a history of febrile urinary tract infection (fUTI) were analyzed retrospectively. From January 2016 to July 2018, routine VCUG following EI was performed on all children. Thereafter, postoperative VCUG was performed only if indicated. Clinical success was defined as no fUTI during a 12-month follow-up, and radiographic success was defined as the disappearance of VUR on postoperative VCUG. The clinical and radiographic outcomes in both groups were compared. Results: Thirty-six children were analyzed in this study. Three children (8.3%) experienced postoperative fUTI. In the routine group, clinical and radiographic success was observed in 16/17 (94.1%) and 15/17 (88.2%), respectively. Two children in the routine group experienced radiographic failure. Among these, one child showed clinical success, and the other underwent additional EI due to clinical failure. Of the indicated group, clinical failure was observed in 2/19 (10.5%). Of them, persistent VUR was identified in one child. Conclusions Clinical and radiologic success after EI for primary low-grade VUR is high, and routine VCUG for confirming radiographic success has a limited impact on the clinical course.

Purpose: An endoscopic subureteral injection (EI) using a bulking agent is a highly successful surgical procedure, particularly for low-grade vesicoureteral reflux (VUR). Despite the serious adverse effects, routine voiding cystourethrogram (VCUG) to determine radiographic success after EI remains controversial. This study evaluated the necessity of routine postoperative VCUG in children with primary low-grade VUR. Materials and Methods: From January 2016 to August 2021, children who underwent EI for primary low-grade (I-III) VUR with a history of febrile urinary tract infection (fUTI) were analyzed retrospectively. From January 2016 to July 2018, routine VCUG following EI was performed on all children. Thereafter, postoperative VCUG was performed only if indicated. Clinical success was defined as no fUTI during a 12-month follow-up, and radiographic success was defined as the disappearance of VUR on postoperative VCUG. The clinical and radiographic outcomes in both groups were compared. Results: Thirty-six children were analyzed in this study. Three children (8.3%) experienced postoperative fUTI. In the routine group, clinical and radiographic success was observed in 16/17 (94.1%) and 15/17 (88.2%), respectively. Two children in the routine group experienced radiographic failure. Among these, one child showed clinical success, and the other underwent additional EI due to clinical failure. Of the indicated group, clinical failure was observed in 2/19 (10.5%). Of them, persistent VUR was identified in one child. Conclusions Clinical and radiologic success after EI for primary low-grade VUR is high, and routine VCUG for confirming radiographic success has a limited impact on the clinical course.

Purpose: An endoscopic subureteral injection (EI) using a bulking agent is a highly successful surgical procedure, particularly for low-grade vesicoureteral reflux (VUR). Despite the serious adverse effects, routine voiding cystourethrogram (VCUG) to determine radiographic success after EI remains controversial. This study evaluated the necessity of routine postoperative VCUG in children with primary low-grade VUR. Materials and Methods: From January 2016 to August 2021, children who underwent EI for primary low-grade (I-III) VUR with a history of febrile urinary tract infection (fUTI) were analyzed retrospectively. From January 2016 to July 2018, routine VCUG following EI was performed on all children. Thereafter, postoperative VCUG was performed only if indicated. Clinical success was defined as no fUTI during a 12-month follow-up, and radiographic success was defined as the disappearance of VUR on postoperative VCUG. The clinical and radiographic outcomes in both groups were compared. Results: Thirty-six children were analyzed in this study. Three children (8.3%) experienced postoperative fUTI. In the routine group, clinical and radiographic success was observed in 16/17 (94.1%) and 15/17 (88.2%), respectively. Two children in the routine group experienced radiographic failure. Among these, one child showed clinical success, and the other underwent additional EI due to clinical failure. Of the indicated group, clinical failure was observed in 2/19 (10.5%). Of them, persistent VUR was identified in one child. Conclusions Clinical and radiologic success after EI for primary low-grade VUR is high, and routine VCUG for confirming radiographic success has a limited impact on the clinical course.