{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T23:15:06Z","timestamp":1777418106680,"version":"3.51.4"},"reference-count":19,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2009,3,31]],"date-time":"2009-03-31T00:00:00Z","timestamp":1238457600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Ann Pharmacother"],"published-print":{"date-parts":[[2009,4]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To evaluate the efficacy and safety of various treatment options for osteopenia and osteoporosis secondary to cancer treatment in pediatric patients undergoing cancer therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Sources:<\/jats:title>\n                    <jats:p>A systematic search of PubMed (1949\u2013November 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Selection and Data Extraction:<\/jats:title>\n                    <jats:p>All prospective studies that evaluated various osteoporosis treatment options in pediatric patients undergoing chemotherapy were included. Results from studies evaluating bisphosphonates and other treatments in children with osteoporosis due to other causes were also included if important safety and efficacy data were provided. Most commonly reported primary efficacy endpoints included comparisons of bone density parameters measured before and after treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Synthesis:<\/jats:title>\n                    <jats:p>Four clinical studies and 2 case reports describing treatment with bisphosphonates, specifically alendronate and Pamidronate, for osteoporosis or osteopenia in pediatric cancer patients were identified. Results from the trials showed that these medications were efficacious in reducing bone mineral density loss during cancer therapy and were well tolerated in this special population. Primary efficacy endpoints included improvements in Z-scores measured by dual-energy X-ray absorptiometry scans. The most commonly reported adverse effects included hypocalcemia, mild stomach upset, and infusion-related hyperpyrexia. Four additional clinical trials involving the treatment of osteoporosis or osteopenia in children and adolescents who developed bone degeneration after chronic steroid therapy are also included. In these trials, treatment options such as calcitonin, and calcium and vitamin D supplementation were also shown to be beneficial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>The clinical trials published to date are limited to only a few conducted in small populations of patients diagnosed with lymphoblastic leukemia or non\u2013Hodgkin's lymphoma. However, alendronate and Pamidronate both appeared to be effective options in improving bone mineral density scores with minimal adverse effects.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1345\/aph.1l567","type":"journal-article","created":{"date-parts":[[2009,3,31]],"date-time":"2009-03-31T22:00:14Z","timestamp":1238536814000},"page":"714-720","source":"Crossref","is-referenced-by-count":4,"title":["Treatment of Osteoporosis\/Osteopenia in Pediatric Leukemia and Lymphoma"],"prefix":"10.1177","volume":"43","author":[{"given":"Michele L","family":"Bryant","sequence":"first","affiliation":[{"name":"Pharmacy Practice Resident, Children's Hospital, Birmingham, AL"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mary A","family":"Worthington","sequence":"additional","affiliation":[{"name":"Pharmacy Practice, Samford University McWhorter School of Pharmacy; Pediatric Clinical Pharmacy Specialist, Children's Hospital, Birmingham"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kerry","family":"Parsons","sequence":"additional","affiliation":[{"name":"Pediatric Hematology\/Oncology Clinical Pharmacy Specialist, Children's Hospital, Birmingham"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2009,3,31]]},"reference":[{"key":"bibr1-aph.1L567","unstructured":"American Cancer Society. Cancer facts and figures 2007. www.xancer.org\/downloads\/STT\/CAFF2007PWSecured.pdf (accessed 2008 Feb 16)."},{"key":"bibr2-aph.1L567","unstructured":"National Osteoporosis Foundation. Osteoporosis: fast facts, www.nof.org\/osteoporosis\/diseasefacts.htm (accessed 2008 Feb 25)."},{"key":"bibr3-aph.1L567","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.22546"},{"key":"bibr4-aph.1L567","first-page":"924","volume-title":"Saunders manual of pediatric practices","author":"Bachrach L","year":"2002","edition":"2"},{"key":"bibr5-aph.1L567","first-page":"1645","volume-title":"Pharmacotherapy: a pathophysiologic approach","author":"O'connell MB","year":"2005","edition":"6"},{"key":"bibr6-aph.1L567","doi-asserted-by":"publisher","DOI":"10.1515\/JPEM.2001.14.7.833"},{"key":"bibr7-aph.1L567","doi-asserted-by":"publisher","DOI":"10.1385\/JCD:7:1:17"},{"key":"bibr8-aph.1L567","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.21407"},{"key":"bibr9-aph.1L567","unstructured":"Children's Oncology Group. Long-term follow-up guidelines for sur vivors of childhood, adolescent, and young adult cancers. www.survivorshipguidelines.org (accessed 2007 Aug 3)."},{"key":"bibr10-aph.1L567","doi-asserted-by":"publisher","DOI":"10.1191\/1078155205jp145oa"},{"key":"bibr11-aph.1L567","doi-asserted-by":"publisher","DOI":"10.1097\/MPH.0b013e318142b7a1"},{"key":"bibr12-aph.1L567","doi-asserted-by":"publisher","DOI":"10.1515\/jpem-2006-190410"},{"key":"bibr13-aph.1L567","doi-asserted-by":"publisher","DOI":"10.1002\/mpo.10057"},{"key":"bibr14-aph.1L567","doi-asserted-by":"publisher","DOI":"10.1080\/08880010500198285"},{"key":"bibr15-aph.1L567","doi-asserted-by":"publisher","DOI":"10.1007\/s00467-004-1790-8"},{"key":"bibr16-aph.1L567","doi-asserted-by":"publisher","DOI":"10.1016\/j.bone.2007.05.002"},{"key":"bibr17-aph.1L567","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-3046.2004.00191.x"},{"key":"bibr18-aph.1L567","doi-asserted-by":"publisher","DOI":"10.1007\/s00467-005-2118-z"},{"key":"bibr19-aph.1L567","doi-asserted-by":"publisher","DOI":"10.1345\/aph.1H521"}],"container-title":["Annals of Pharmacotherapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1345\/aph.1L567","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1345\/aph.1L567","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T11:06:27Z","timestamp":1777374387000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1345\/aph.1L567"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2009,3,31]]},"references-count":19,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2009,4]]}},"alternative-id":["10.1345\/aph.1L567"],"URL":"https:\/\/doi.org\/10.1345\/aph.1l567","relation":{},"ISSN":["1060-0280","1542-6270"],"issn-type":[{"value":"1060-0280","type":"print"},{"value":"1542-6270","type":"electronic"}],"subject":[],"published":{"date-parts":[[2009,3,31]]}}}