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Flow chart depicts the use of bisphosphonates and overall monitoring recommendations for children and adolescents with acute lymphoblastic leukemia induced osteoporosis. * Bi-annual dual-energy X-ray absorptiometry should be considered if factors associated with bone morbidity worsen. BP, bisphosphonate; BMD, bone mineral density; DXA, dual-energy X-ray absorptiometry, VF, vertebral fracture; z-score, standard deviation score.
