Osteoporosis at presentation of childhood ALL: management with pamidronate
Child; Female; Humans; Male; Leukemia; Preschool; Clodronate; Acute; Lymphocytic; Bone Density/drug effects; Diphosphonates/administration & dosage; Fractures; Bone Density Conservation Agents/administration & dosage; L1/complications/radiography/therapy; Osteoporosis/drug therapy/etiology/radiography; Spinal Fractures/drug therapy/etiology/radiography; Spontaneous/drug therapy/etiology/radiography
Vertebral fractures at diagnosis of childhood acute lymphoblastic leukemia (ALL) are an uncommon but recognized problem. Clinical issues associated with pathological fractures in these children include pain control and the potential for further treatment-associated fractures and long-term bony morbidity. The authors report the successful use of pamidronate in two children who presented with vertebral compression fractures at diagnosis of ALL. Both patients had pain and low bone mineral density at baseline. In addition to standard chemotherapy, pamidronate (1 mg/kg, IV) was given bimonthly. Initial rapid symptom relief and gradual improvement of bone mineral density was demonstrated in both patients.
2005
Goldbloom EB; Cummings EA; Yhap M
Pediatric Hematology And Oncology
2005
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Journal Article
<a href="http://doi.org/10.1080/08880010500198285" target="_blank" rel="noreferrer">10.1080/08880010500198285</a>
The use of subcutaneous pamidronate
Humans; Injections; Subcutaneous; Clodronate; Hypercalcemia/drug therapy; Anti-Inflammatory Agents/administration & dosage; Diphosphonates/administration & dosage
2003
Duncan AR
Journal Of Pain And Symptom Management
2003
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Journal Article
<a href="http://doi.org/10.1016/s0885-3924(03)00225-2" target="_blank" rel="noreferrer">10.1016/s0885-3924(03)00225-2</a>
Cyclic administration of pamidronate in children with severe osteogenesis imperfecta
Child; Female; Humans; Male; Drug Administration Schedule; adolescent; Preschool; Non-U.S. Gov't; Research Support; Pain/drug therapy; Clodronate; Bone Density/drug effects; Periodicity; Diphosphonates/administration & dosage; Alkaline Phosphatase/blood; Bone Development/drug effects; Bone Resorption/drug therapy; Bone/prevention & control; Calcium/urine; Fractures; Lumbar Vertebrae/physiopathology/radiography; Osteogenesis Imperfecta/drug therapy/metabolism/physiopathology
BACKGROUND: Severe osteogenesis imperfecta is a disorder characterized by osteopenia, frequent fractures, progressive deformity, loss of mobility, and chronic bone pain. There is no effective therapy for the disorder. We assessed the effects of treatment with a bisphosphonate on bone resorption. METHODS: In an uncontrolled observational study involving 30 children who were 3 to 16 years old and had severe osteogenesis imperfecta, we administered pamidronate intravenously (mean [+/-SD] dose, 6.8+/-1.1 mg per kilogram of body weight per year) at 4-to-6-month intervals for 1.3 to 5.0 years. Clinical status, biochemical characteristics reflecting bone turnover, the bone mineral density of the lumbar spine, and radiologic changes were assessed regularly during treatment. RESULTS: Administration of pamidronate resulted in sustained reductions in serum alkaline phosphatase concentrations and in the urinary excretion of calcium and type I collagen N-telopeptide. There was a mean annualized increase of 41.9+/-29.0 percent in bone mineral density, and the deviation of bone mineral density from normal, as indicated by the z score, improved from -5.3+/-1.2 to -3.4+/-1.5. The cortical width of the metacarpals increased by 27+/-20.2 percent per year. The increases in the size of the vertebral bodies suggested that new bone had formed. The mean incidence of radiologically confirmed fractures decreased by 1.7 per year (P<0.001). Treatment with pamidronate did not alter the rate of fracture healing, the growth rate, or the appearance of the growth plates. Mobility and ambulation improved in 16 children and remained unchanged in the other 14. All the children reported substantial relief of chronic pain and fatigue. CONCLUSIONS: In children with severe osteogenesis imperfecta, cyclic administration of intravenous pamidronate improved clinical outcomes, reduced bone resorption, and increased bone density.
1998
Glorieux FH; Bishop NJ; Plotkin H; Chabot G; Lanoue G; Travers R
The New England Journal Of Medicine
1998
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Journal Article
<a href="http://doi.org/10.1056/nejm199810013391402" target="_blank" rel="noreferrer">10.1056/nejm199810013391402</a>
Osteoporosis pseudoglioma syndrome: treatment of spinal osteoporosis with intravenous bisphosphonates
Child; Female; Humans; Male; Analgesics; Growth; Non-U.S. Gov't; Research Support; Syndrome; Infusions; Intravenous; Clodronate; Pain/prevention & control; Clodronic Acid/administration & dosage; Non-Narcotic/administration & dosage; Diphosphonates/administration & dosage; Fractures; Bone Density/physiology; Bone/complications/physiopathology; Osteoporosis/complications/drug therapy/physiopathology; Spine/physiopathology; Vision Disorders/complications
OBJECTIVES: To determine whether intravenous bisphosphonate treatment is helpful for children with osteoporosis pseudoglioma syndrome who have severe osteoporosis. METHODS: Three children (ages 9 to 11 years) with osteoporosis pseudoglioma syndrome who had multiple vertebral collapse were treated over a 2-year period with intermittent intravenous bisphosphonate infusions (pamidronate in 2, clodronate in 1). The responses to therapy were assessed with clinical and radiographic evaluation and bone densitometry of the spine. RESULTS: All 3 subjects reported early reductions in bone pain and improved mobility. Radiographs showed dense new bone in the vertebral end plates and remodeling of the vertebral bodies. Areal bone mineral density at the lumbar spine (age-appropriate SD score) improved from a mean of -4.5 before treatment to -2.8 after 2 years (P <.05). No new fractures occurred, and side effects were minimal. Growth and pubertal development proceeded normally. CONCLUSIONS: Intravenous bisphosphonate therapy appears safe and beneficial in patients with this condition and may prevent progressive vertebral deformity.
2000
Zacharin M; Cundy T
The Journal Of Pediatrics
2000
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Journal Article
<a href="http://doi.org/10.1067/mpd.2000.107838" target="_blank" rel="noreferrer">10.1067/mpd.2000.107838</a>