Adverse Family Outcomes in Children With B-Cell Acute Lymphoblastic Leukemia From the Multicenter Trial Children's Oncology Group AALL0932.

Authors

Rozalyn L Rodwin, John A Kairalla, Emily Hibbitts, Lyn M Balsamo, Meenakshi Devidas, Brenna Mossman, Alexandra Dreyzin, Naomi J Winick, Lillian Sung, Claire Conley, William L Carroll, Stephen P Hunger, Elizabeth Raetz, Kirsten K Ness, Mignon L Loh, Reuven J Schore, Anne L Angiolillo, Nina S Kadan-Lottick

Published in

Journal of the National Comprehensive Cancer Network : JNCCN. Volume 24. Issue 10.

Abstract

Treatment for B-cell acute lymphoblastic leukemia (B-ALL) lasts >2 years and can impact families. The Children's Oncology Group multicenter therapeutic trial AALL0932 randomized patients with NCI standard-risk, average-risk B-ALL (NCI-SR AR B-ALL) to receive maintenance vincristine/dexamethasone every 4 or 12 weeks (VCR/DEX4 or VCR/DEX12, respectively). Embedded in AALL0932, this study aimed to (1) longitudinally measure adverse family outcomes overall, and (2) determine whether patients on the VCR/DEX4 regimen (vs VCR/DEX12) had fewer adverse family outcomes.
Patients with NCI-SR AR B-ALL who were offered enrollment on the multicenter randomized-controlled therapeutic trial AALL0932 were aged ≥4 years with an English-speaking parent. Parent-reported surveys were administered at T1-T5 (approximately 2, 9, 18, 26, and 38 months after diagnosis, respectively; T5 was assessed only in boys) and assessed household changes since leukemia diagnosis, leukemia-related household expenses in the past 4 weeks, unhealthy family functioning (Family Assessment Device score >2), and parents' perceived child vulnerability (Child Vulnerability Scale ≥10). Postrandomization outcomes at T3 and T4 were compared between treatment groups using generalized linear mixed models and multivariable logistic regression models, as appropriate, adjusting for race and ethnicity.
Among 555 participants with completed evaluations, 420 were randomized (mean [SD] age, 6.0 [1.6] years; 45.7% female). At T1, 56.2% of randomized participants reported household changes since diagnosis (81.2% by T4), 88.6% reported ≥$100 in leukemia-related household expenses in the past 4 weeks (61.5% at T4), 19.0% had unhealthy family functioning (23.9% at T4), and 55.8% perceived their child as vulnerable (62.5% at T4). In multivariable models, VCR/DEX4 (vs VCR/DEX12) had an increased likelihood of reporting ≥$100 in leukemia-related expenses in the past 4 weeks (odds ratio, 1.73; 95% CI, 1.03-2.91), but other outcomes were similar between treatment arms.
B-ALL family burdens develop early. Reducing maintenance VCR/DEX frequency may decrease expenses but not other outcomes. Interventions are needed to support families early and throughout ALL therapy.

PMID:
42869069
Bibliographic data and abstract were imported from PubMed on 14 Oct 2026.

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