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Bisphosphonate use in children with leukemia

Anar Tagiyev, Huseyin Demirbilek, Betul Tavil, Gonul Buyukyilmaz, Fatma Gumruk, Mualla Cetin
Hypercalcemia is a rare complication of hematological malignancy in children. An 8-year-old girl with CALLA (+) Pre-B-cell ALL developed hypercalcemia during bone marrow relapse. She had nausea, vomiting, leg pain, polyuria, polydipsia, and muscle weakness. At the time of relapse, the ionized calcium level was 1.99 mmol/L. Rehydration with 0.9% saline and furosemide and methylprednisolone (MP) treatment were used for the treatment of hypercalcemia. The serum ionized calcium level increased to 2.2 mmol/L despite hydration, furosemide, and MP treatment...
April 2016: Journal of Pediatric Hematology/oncology
Mariël L Te Winkel, Rob Pieters, Ernst-Jan D Wind, J H J M Gert Bessems, Marry M van den Heuvel-Eibrink
There is no consensus regarding how to manage osteonecrosis in pediatric acute lymphoblastic leukemia patients. Therefore, we performed a quality assessment of the literature with the result of a search strategy using the MESH terms osteonecrosis, children, childhood cancer, surgery, bisphosphonates, 6 hydroxymethyl-glutaryl CoA reductase inhibitors, anticoagulants and hyperbaric oxygen, and terms related to these MESH terms. A randomized controlled trial showed that osteonecrosis can be prevented by intermittent, instead of continuous, corticosteroid administration...
March 2014: Haematologica
Jae Min Lee, Ji Eun Kim, Soon Hwan Bae, Jeong Ok Hah
BACKGROUND: Reduced bone mineral density (BMD) is a significant sequelae in children receiving chemotherapy for acute lymphoblastic leukemia (ALL) and non-Hodgkin lymphoma (NHL). Reduced BMD is associated with an increased risk for fractures. Pamidronate, a second-generation bisphosphonate, has been used to treat osteoporosis in children. This study evaluated the safety and efficacy of pamidronate in children with low BMD during and after chemotherapy for ALL and NHL. METHODS: Between April 2007 and October 2011, 24 children with ALL and NHL were treated with pamidronate...
June 2013: Blood Research
Michele L Bryant, Mary A Worthington, Kerry Parsons
OBJECTIVE: To evaluate the efficacy and safety of various treatment options for osteopenia and osteoporosis secondary to cancer treatment in pediatric patients undergoing cancer therapy. DATA SOURCES: A systematic search of PubMed (1949-November 2008) and International Pharmaceutical Abstracts (to November 2008) was conducted using the following search terms: osteoporosis, osteopenia, pediatrics, cancer, neoplasms, chemotherapy, bisphosphonates, calcium, vitamin D, calcitonin, and physical therapy...
April 2009: Annals of Pharmacotherapy
Christopher Lethaby, John Wiernikowski, Alessandra Sala, Marissa Naronha, Colin Webber, Ronald D Barr
BACKGROUND: Osteopenia is a common consequence of the treatment of acute lymphoblastic leukemia (ALL) in children and adolescents, due predominantly to glucocorticosteroid therapy. The pathogenesis relates to an imbalance of resorption over formation of bone. METHODS: Alendronate (Fosamax), an inhibitor of osteoclastic bone resorption, was administered for at least 6 months to 15 children with ALL during maintenance chemotherapy, after the diagnosis of osteopenia/osteoporosis by dual energy x-ray absorptiometry...
September 2007: Journal of Pediatric Hematology/oncology
Nesibe Andiran, Ayfer Alikaşifoğlu, Serhan Küpeli, Sevgi Yetgin
Hypercalcemia is a rare complication of malignancy in children. We present two children, one of whom is the youngest reported, with CALLA+ B-cell acute lymphoblastic leukemia (ALL) who developed hypercalcemia at the time of diagnosis and were treated with relatively low-dose (0.5 mg/kg) intravenous pamidronate successive to conventional therapy. No major side effects were encountered except transient hypocalcemia and hypophosphatemia, which were easily managed by replacement therapy. Bisphosphonate therapy was found to be beneficial for the treatment of resistant hypercalcemia associated with ALL, even at relatively low doses...
July 2006: Turkish Journal of Pediatrics
I Schmid, D Stachel, C Schön, M Bauer, R J Haas
Severe symptomatic hypercalcemia is a rare event in children with malignancies. Up to now there is limited experience treating childhood hypercalcemia with bisphosphonates in addition to calcitonin. We report a 5-year-old boy with acute lymphoblastic lymphoma who presented with malignant hypercalcemia at diagnosis. The maximal serum calcium concentration was 15.2 mg/dl (3.81 mmol/l). Conventional therapy with forced diuresis and furosemide failed. Calcitonin (10 IU/kg/24 h i.v. for 2 days) and pamidronate (1 mg/kg over 2 hours i...
January 2001: Klinische Pädiatrie
A N Lteif, D Zimmerman
Most clinicians only have a limited experience in treating childhood hypercalcemia with bisphosphonates. We report our experience in the use of intravenous and oral bisphosphonates in a 5-year-old with hypercalcemia secondary to acute lymphocytic leukemia, a 16-year-old with immobilization hypercalcemia, and a 14-year-old with chronic hypercalcemia of unknown cause. Single infusions of 0.5 mg/kg and 1 mg/kg of intravenous pamidronate were administered over 4 hours. No adverse reactions were observed except for hypocalcemia...
October 1998: Pediatrics
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