Bone Mineral Density in Adult Survivors of Solid Pediatric Cancers
Condition: Regional Osteoporosis as a Result of Chemotherapy
MeSH terms: Osteoporosis
Study type: Observational

Summary: 
      Specific subgroups of children who survive treatment for childhood malignancies have been
      shown to develop relative osteopenia following chemotherapy and are felt to be at risk for
      developing osteoporosis later in life due to their inability to reach peak bone mass during
      childhood.
    

Detailed description: 
      Specific subgroups of children who survive treatment for childhood malignancies have been
      shown to develop relative osteopenia following chemotherapy and are felt to be at risk for
      developing osteoporosis later in life due to their inability to reach peak bone mass during
      childhood. However, currently, there is no conclusive evidence that survivors of pediatric
      solid malignancies are at risk for these problems due to small numbers of patients analyzed.
      Our SUNY Upstate Medical University Pediatric Oncology Long-term Follow-up Clinic has
      recently established a coalition of other upstate New York cancer centers which allows access
      to a large number of these patients. The purpose is to perform a cross-sectional study of
      bone mineral density using dual-energy X-ray absorptiometry (DEXA) in adult survivors of
      solid pediatric tumors. The primary hypothesis is that pediatric solid cancer survivors will
      demonstrate significantly lower bone mineral density (BMD) compared to established age group
      controls. Identification of these patients as high risk for development of osteoporosis will
      allow clinical trials using novel and established agents.

      This study has been ongoing for 5 years. To date there have been no problems with the conduct
      of this study. A total of 38 subjects that have been enrolled. Analysis of research to date
      reveals that solid tumor survivors are at increased risk for early osteopenia/osteoporosis.
      No subjects have withdrawn or been excluded for any reason other than inclusion/exclusion
      criteria since inception of the study. The study will be ongoing for recruitment of subjects
      and analysis.

      There was one amendment made to the protocol. The amendment was to increase the upper age of
      the subjects to 40 years. This amendment was made due to that although our multivariate
      analysis showed a relationship with number of chemotherapy drugs, our statistical power to
      examine according to multiple other variables, such as individual diagnosis, was limited by
      the relatively small numbers of patients.

      An article was submitted to the Journal of Pediatric Hematology Oncology and printed in the
      May 2005 issue.
    

Intervention name(s): DXA Scan
Intervention type(s): Radiation
Intervention description(s): The patients will undergo total body, spine, proximal femoral, and forearm DEXA testing in a standardized fashion. Patients who have undergone limb surgery or irradiation to an extremity for local disease control will also undergo selected site DEXA or pQCT scanning, depending upon the site, of the affected extremity and the identical site on the contra-lateral extremity.
Observational model: Case-Only
Time perspective: Cross-Sectional
Sampling method: Non-Probability Sample
Study population: 
        Subjects will be recruited from the Oncology Clinic by one of the sub-investigators.