Harris AM, et al. - Ten full-text papers were recognized with two exclusively meeting the inclusion criteria by the researchers in order to assess the impacts of bisphosphonates on bone mineral density and fracture incidence in children with acute lymphoblastic leukemia (ALL). Both studies gave bisphosphonates to children who received maintenance chemotherapy for different terms. Bone density was evaluated at regular intervals via dual x-ray absorptiometry (DXA). At the end of each study, the majority of individuals had betterment in bone density. Nonetheless, no size adjustment of DXA data was conducted. Limited information on fracture occurrence was given by one study although, did not incorporate routine screening for vertebral fractures. Therefore, for the prevention of fracture and betterment of bone mass, there was inadequate evidence to support the routine use of prophylactic bisphosphonate therapy in childhood ALL. Moreover, in those at greatest risk of fractures in ALL, additional well-designed clinical trials are now required.