Parent Quality of Life at Two Years Following Their Child's Completion of Acute Lymphoblastic Leukemia Treatment

Parents of children treated for acute lymphoblastic leukemia (ALL) often experience significant caregiver burden and disruption to their well-being. While parent quality of life (QoL) during treatment is well characterized, little is known about outcomes during early survivorship. This study aimed to (1) compare QoL among patient parents and parents of healthy children at 27 months post-treatment and (2) examine predictors assessed at 3 months post-treatment.

Study participants were 83 patient parents and 53 parents of healthy peers from the longitudinal ALLaboard study. Parent QoL was assessed at 27 months utilizing a validated QoL self-report measure. Predictors of QoL examined included demographic, treatment, parent psychological, and child behavioral factors at the end of treatment. Group differences were examined using paired t-tests and hierarchical regressions.

Patient parents reported significantly lower psychological, social, and environmental QoL, with environmental QoL most severely impaired. No difference was observed in physical QoL. Parental distress at 3 months predicted poorer psychological, social, and environmental QoL at 27-months (β = -0.28 to -0.40), while child internalizing behaviors predicted poorer physical QoL (β = -0.36). Older parental age predicted better social QoL (β = 0.32). Treatment intensity was not associated with QoL outcomes.

Parents of patients treated for ALL experience persistent QoL difficulties during the early survivorship period following treatment completion. Elevated parental distress and child internalizing behaviors at the end of treatment are risk factors for poorer outcomes, demonstrating bidirectional parent-child relationships. Early survivorship programs should incorporate systematic, family-level psychosocial screening at treatment completion and family-focused interventions.