Pain Experiences During Early Treatment for Pediatric Acute Lymphoblastic Leukemia: A Qualitative Study

Pain is a common and distressing symptom for pediatric patients with acute lymphoblastic leukemia (ALL), arising from the disease itself, its treatment, and associated medical procedures. The early phase of treatment is particularly challenging, as children experience multiple, rapidly evolving sources of pain. Despite its prevalence, pain during this period remains poorly characterized. This study qualitatively examined pain experiences among children with ALL during induction and early consolidation.

Twenty caregivers of children with ALL (ages 2-17) and eight patients (ages 8-17) participated in two semi-structured interviews capturing pain experiences across early treatment. Interviews were audio-recorded, transcribed, and analyzed using thematic analysis.

Eight themes described key dimensions of the pain experience: Sources of Pain, Pain Characteristics, Pain-Related Symptoms, Factors Influencing Pain, Pain Impact, Pain Expression, Pain Management Tools, and Barriers to Pain Management. These themes reflected the evolving, multidimensional nature of pain during early treatment.

Children with ALL experience substantial and multifaceted pain early in their cancer trajectory. Findings underscore the need for early, developmentally informed, and family-centered approaches to pain assessment and management that address the complex and evolving nature of pain during initial treatment.