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Dr Peck of Washington University (St Louis) has rightly pointed out in the above letter that the leukemogenic potential of clodronate has not been excluded. We did not mean to indicate that clodronate should be made immediately available until this potential problem has been completely evaluated. We certainly would not advocate the use of clodronate should it be proved to be associated with the emergence of treatment-related leukemia, and point out in the last paragraph of our article that only, "If the risk of clodronate-associated acute leukemia can be shown to be insignificant, clodronate should be able to take its place next to mithramycin and calcitonin in the armamentarium against cancer-related hypercalcemia." We feel that the observation of three cases of acute leukemia in 664 patients would have caused any investigator to rightly question the advisability of further trials until this association had been more rigorously examined. We did
Witte RS. Results of a Randomized Study of Clodronate in Treating Cancer-Related Hypercalcemia-Reply. Arch Intern Med. 1987;147(11):2056-2057. doi:10.1001/archinte.1987.00370110184033