title: Bone loss and vitamin D deficiency in children undergoing hematopoietic cell transplantation.
abstract: BACKGROUND
  Hematopoietic cell transplantation (HCT) may be detrimental to bone health and vitamin D status in children.
  
  
  METHODS
  We conducted a prospective, multicenter cohort study to identify changes in bone health markers during the first 100 days after allogeneic HCT in 26 children. Bone mineral density (BMD), bone mineral content (BMC), and serum 25-hydroxyvitamin D (25OHD) concentrations were measured at baseline, 30 days, and 100 days after HCT.
  
  
  RESULTS
  Mean (SD) BMD and BMC Z-scores (-0.48 ± 1.09 and -0.98 ± 1.26, respectively) were normal at baseline. Repeated-measures analysis revealed significant declines in BMD and BMC Z-scores over the 100 day study period, when adjusted for age, sex, Tanner stage, lean mass, fat mass, resting energy expenditure, total energy intake, insulin sensitivity, serum phosphorus, and inpatient steroid intake. Adjusted mean (SE) 25OHD concentrations declined from 29.2 (3.1) ng/ml at baseline, to 17.7 (1.8) ng/ml at 100 days after HCT. Vitamin D deficiency (25OHD <20 ng/ml) was present in 50% of patients 100 days after HCT.
  
  
  CONCLUSIONS
  Significant bone loss and vitamin D deficiency occur in children in the first 100 days following allogeneic HCT. Strategies to diminish acute bone loss during HCT in children are needed.
authors: Center for Nutrition, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA; Dana-Farber Cancer Institute, Boston, MA.
authors: Lori J
authors: LJ
authors: Bechard
authors: Catherine
authors: C
authors: Gordon
authors: Henry A
authors: HA
authors: Feldman
authors: Robert
authors: R
authors: Venick
authors: Kathleen
authors: K
authors: Gura
authors: Eva C
authors: EC
authors: Guinan
authors: Christopher
authors: C
authors: Duggan
mesh_terms: D000293:Adolescent; D000367:Age Factors; D064591:Allografts; D015519:Bone Density; D002648:Child; D004311:Double-Blind Method; D005500:Follow-Up Studies; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008297:Male; D010024:Osteoporosis / Q000097:blood / Q000453:epidemiology / Q000209:etiology; D011446:Prospective Studies; D012737:Sex Factors; D014807:Vitamin D / Q000031:analogs & derivatives / Q000097:blood; D014808:Vitamin D Deficiency / Q000097:blood / Q000453:epidemiology / Q000209:etiology
chemical_list: D014807:Vitamin D; C104450:25-hydroxyvitamin D
keywords: bone demineralization; bone density; hematopoietic cell transplantation; vitamin D
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