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Parental functioning during maintenance treatment for childhood acute lymphoblastic leukemia: Effects of treatment

Niki Rensen1,2, Lindsay M H Steur2, Martha A Grootenhuis1

  • 1Princess Máxima Center for Pediatric Oncology, Utrecht, Netherlands.

Pediatric Blood & Cancer
|September 10, 2020
PubMed

Insights

Parents of children with acute lymphoblastic leukemia (ALL) experience significant sleep disturbances and distress. Medium-risk ALL patients’ parents reported higher distress than standard-risk parents, regardless of dexamethasone treatment.

Area of Science:

  • Pediatric Oncology
  • Psychosocial Oncology

Background:

  • Acute lymphoblastic leukemia (ALL) treatment involves chemotherapy and dexamethasone, impacting children's sleep and behavior.
  • Stratified therapy effects on parents' well-being are not well understood.
  • Dexamethasone's impact on pediatric ALL patients and their parents requires further investigation.

Purpose of the Study:

  • To compare parental sleep, distress, and quality of life (QoL) in medium-risk (MR) and standard-risk (SR) pediatric ALL patients.
  • To assess the impact of dexamethasone on parental well-being within the MR group.
  • To compare parental outcomes to the general population.

Main Methods:

  • Parents of MR and SR ALL patients completed validated questionnaires (MOS sleep, distress thermometer, SF-12) at one year post-diagnosis.
  • MR parents completed assessments both on and off cyclic dexamethasone.
  • Parental outcomes were compared to reference values and between MR and SR groups using multilevel regression analysis.

Main Results:

  • Parents of ALL patients reported more sleep disturbances, higher distress, and lower mental QoL compared to reference values.
  • MR parents reported significantly higher distress levels than SR parents (mean 4.8 vs 3.5).
  • Parental sleep, distress, and QoL did not significantly differ within the MR group, regardless of dexamethasone use.

Conclusions:

  • Parents of pediatric ALL patients experience substantial psychosocial burden, including sleep problems and distress.
  • MR parents exhibit higher distress than SR parents, potentially due to treatment intensity and prognostic factors.
  • Psychosocial support is crucial for parents throughout ALL treatment, irrespective of risk stratification.
Abstract

Keywords:
ALLdexamethasoneparentspsychosocialquality of lifesleep

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