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Published on: October 17, 2025
Dynamic Trajectory of Quality of Life Among Children With Acute Lymphoblastic Leukemia From a Parental Proxy
Thu Hang Tran Thi1, Chung-Ying Lin, Jung-Der Wang
1Author Affiliations: Faculty of Nursing and Medical Technology, The Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam (Tran Thi); Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan (Lin); School of Nursing, College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan (Lin); Department of Public Health, College of Medicine (Wang), Department of Occupational and Environmental Medicine, National Cheng Kung University Hospital, Tainan, Taiwan (Wang); National Tainan Junior College of Nursing, Tainan, Taiwan (Huang); and Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan (Huang).
Background:
Quality of life (QoL) among children with acute lymphoblastic leukemia (ALL) exhibits dynamic changes during various treatment periods.
Objective:
This study explores the longitudinal trends in and determinants of QoL among children with ALL postdiagnosis.
Methods:
We conducted this study using repeated measurements with a kernel smoothing mean. We consecutively recruited ALL patients aged 5-18 years and their parental proxies from 3 hospitals in Vietnam. They reported their children's QoL by the PedsQL Generic Core Scales and the PedsQL Cancer Module.
Results:
We collected a total of 277 repeated assessments for 186 children, and their proxies had a mean age of 38.21 ± 9.01 years. Different age groups experienced distinct QoL problems across various time periods: poor physical functioning (5-7 years: first 5 months; 8-12 years: first year; 13-18 years: second year), pain (5-7 years: first 3 months, 13-18 years: second year), nausea (5-12 years: first 3 months; 13-18 years: second year), procedural anxiety (5-7 years: first 3 months; 8-12 years: first 9 months, 13-18 years: second year), appearance concerns (5-7 years: second year). Duration-to-date, proxy characteristics (education, relationship to the patient) exhibited independent effects on various QoL domains.
Conclusions:
Impairments in QoL functioning and problems emerged and changed across different age groups over time. Several factors, including duration to date and proxy characteristics (education, relationship to the patient), were found to be associated with various QoL domains.
Implications For Practice:
A comprehensive program focusing on physical or psychological problems among children with ALL should be developed.
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