Vitamin D and Calcium Carbonate with or without Pamidronate Disodium in Preventing Bone Loss in Younger Patients Who Have Undergone Stem Cell Transplant to Treat a Hematologic Malignancy

Inclusion Criteria

• Allogeneic hematopoietic cell transplant for hematologic malignancy (i.e. leukemia, lymphoma including acute lymphoblastic leukemia [ALL], acute myeloid leukemia [AML], chronic myelogenous leukemia [CML], non-Hodgkin lymphoma [NHL], Hodgkin lymphoma [HL]) in complete remission; myelodysplastic syndrome (active dysplasia and/or blasts are permitted, but must not have active leukemia) who will be receiving a myeloablative preparative regimen, OR
• Non-malignant diseases including idiopathic severe aplastic anemia (SAA) and other bone marrow failure disorders, hemoglobinopathies, adrenoleukodystrophy, immune deficiencies/dysregulation disorders who will be receiving myeloablative or reduced toxicity preparative regimens that meet the following criteria: * Regimens include those that are total body irradiation (TBI) based if the TBI dose is > 500 cGy single dose or > 800 cGy fractionated, or doses < 500 cGy if combined with busulfan or treosulfan. These also include chemotherapy only based regimens that contain myeloablative doses of busulfan (> 8 mg/kg) or treosulfan without TBI * Patients with severe aplastic anemia are eligible regardless of conditioning regimen
• Patient or parent(s)/legal guardian(s) is able and willing to provide informed consent; assent will be obtained per local institutional policy; subjects who turn 18 during the course of the study will be consented at that time of their next visit by a member of the research staff

Exclusion Criteria

• History of a primary bone malignancy involving the lumbar spine
• Treatment with other biphosphonates, denosumab, or Teriparatide within one year prior to enrollment
• Pregnancy or breastfeeding - menstruating females must have a negative pregnancy test prior to study enrollment and agree to repeat pregnancy testing and contraception use per protocol as pamidronate is Pregnancy Category D – positive evidence of human fetal risk based on adverse reaction data
• Renal insufficiency, defined as creatinine level greater than the upper limit of normal for age
• Hereditary metabolic bone disease or skeletal dysplasia (e.g., osteopetrosis or osteogenesis imperfecta [OI]) or primary hyperparathyroidism
• Non-malignant diseases with underlying metabolic defects that may affect bones such as Hurler’s syndrome and other mucopolysaccharidoses and osteopetrosis, or diseases where the use of hematopoietic cell transplant itself is still under investigation, primarily, epidermolysis bullosa
• Patients with diseases that have increased sensitivity to chemotherapy or radiation including (but not limited to) Fanconi anemia, dyskeratosis congenita
• Clinically significant fractures as defined by International Society for Clinical Densitometry (ISCD) (a long bone fracture of the lower extremities, vertebral compression fracture, or two or more long bone fractures of the upper extremities) indicated by a cast or a spine x-ray within the last 2 weeks
• Known or suspected allergy to pamidronate or related products
• Planned administration of an investigational study drug or agent that either can interact with pamidronate or have an independent effect on bone mineral density within the 4 weeks prior to randomization (day 90) or planned use during study participation (day 90 through day 360)
• Impending invasive dental procedure that would be expected to occur during study participation (through day 360)