BONE MINERAL DENSITY IN CHILDREN AFTER HEMATOPOIETIC STEM CELL TRANSPLANTATION

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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. With the use of more effective anti-cancer therapy and hematopoietic stem cell transplantation (HSCT), more children survive their primary malignancies or are cured of the primary heatologic or metabolic disorders. As a consequence of improved survival, the population of post-HCST patients is increasing and secondary effects of treatment become an important issue. One of the metabolic complications of HSCT is osteoporosis. Adequate bome mineralization is of particular importance in the pediatric population because 45% of peak bone mineral accretion occurs during the most active growth during puberty. Patients who do not reach the optimal bone mineral density (BMD) during this period may suffer from a lifelong debilitating condition. The knowledge of risk factors, incidence, timing, the mechanisms and the magnitude of bone loss following HSCT in children is very limited. At present, no prospective studies have been reported on BMD in children after HSCT. The goal of this pilot study is to collect preliminary prospective data on BMD in children after HSCT. The goal of this pilot study is to collect preliminary prospective data on BMD and markers of bone turnover that would constitute the basis for an application for the external grant support. Each patient will have 4 appointments which will be part of a routine care before and after stem cell transplant, that is 100 days, 6 months, and 12 months after transplant. Each visit will involve a physical examination, blood and urine tests to assess the condition of the bones and various endocrine glands related to the bone growth. In addition, during 3 out of 4 visits, the patients will have a DEXA scan of the bones, which is a non-invasive, painless, safe, and quick method to determine the mineral content of the bones and the risk of osteoporosis. During the initial visit, and at a 1-year follow up visit, the x-ray of the left wrist will be taken to determine the age of the bones, which will be important to interpret the results of the DEXA scan.