Clinical Report: Intravenous Administration of Zoledronate in Children with Bone-Associated LCH
Overview
This report evaluates the use of intravenous zoledronate in eight children with bone-associated Langerhans cell histiocytosis (LCH). All symptomatic patients experienced pain improvement, and the treatment was well tolerated with no significant adverse effects.
Background
Bone involvement in pediatric LCH can lead to significant pain and functional impairment, necessitating effective adjunctive therapies. Zoledronate, a bisphosphonate, has been used off-label to manage painful osseous LCH, aiming to provide rapid relief and promote skeletal healing. Understanding its efficacy and safety in this population is crucial for optimizing treatment strategies.
Data Highlights
Parameter
Outcome
Symptomatic Pain Improvement
100% (4 patients)
Median Time to Improvement
18 days
Radiographic Outcomes
2 complete resolution, 6 improvement
Adverse Effects
Transient fever in 4 patients
Key Findings
All 4 symptomatic patients experienced pain improvement following zoledronate treatment.
The median time to pain improvement was 18 days post-infusion.
Among patients with imaging follow-up, 2 exhibited complete radiographic resolution and 6 showed improvement.
No clinically significant hypocalcemia or osteonecrosis of the jaw was observed in the cohort.
Zoledronate was well tolerated, with transient fever being the most common adverse effect.
Clinical Implications
The findings suggest that intravenous zoledronate can be an effective adjunctive treatment for children with painful bone lesions due to LCH. Clinicians should consider its use in symptomatic patients, particularly those with poor tolerance to oral therapies or progressive disease.
Conclusion
Intravenous zoledronate demonstrates significant potential in alleviating pain and improving radiographic outcomes in pediatric LCH, warranting further investigation in larger cohorts.
