TNF and hematologic disorder: Importantly, many of the underlying diseases themselves carry risk of skeletal fragility, particularly the neuromuscular disorders due to lack of weight-bearing, and the systemic inflammatory and hematological disorders because of the adverse effect of disease-related cytokines on skeletal metabolism (e.g., interleukin [IL] 6 and 1, tumor-necrosis factor-alpha [TNF-α]) (2).