This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Pediatric patients with oncologic conditions, such as leukemia and solid tumors, have a well-documented increase in the risk of decreased bone mineral density (BMD). However, the specific prevalence of decreased BMD in children undergoing the added stress of bone marrow transplant after a primary oncologic diagnosis is not known. Among adults, however, bone marrow transplant is known to be a significant risk for osteoporosis/osteopenia. Furthermore, we do not known the specific risk factors that determine which pediatric patients undergoing bone marrow transplant will have impaired bone mass development. This is significant, as peak bone mass is achieved in adolescence, and entering adulthood with low bone mineral density is known to be a significant risk for adult osteoporosis and bone fragility. This cross-sectional study will evaluate bone density in pediatric bone marrow transplant subjects by measuring DEXA scans of total body and lumbar spine in subjects who are at different stages of bone marrow transplant. We will evaluate subjects from pre-transplant to several years post-transplant. Additionally, we will evaluate potential causes of decreased bone density in this population, including steroid therapy, chemotherapy and radiation therapy regimens, weight-bearing activity, calcium intake, and endocrinologic dysfunction.
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