Dynamic Trajectory of Quality of Life Among Children With Acute Lymphoblastic Leukemia From a Parental Proxy Perspective: A Repeated-Measure Design Using a Kernel Smoothing Method.

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.