Adverse Family Outcomes in Children With B-Cell Acute Lymphoblastic Leukemia From the Multicenter Trial Children's Oncology Group AALL0932
In brief
Every-four-week maintenance brought 73% higher odds of leukemia-related family expenses
In children with standard-risk B-cell acute lymphoblastic leukemia, families reported substantial burdens early: 56% noted household changes and 89% reported at least $100 in recent leukemia-related expenses. Compared with maintenance every 12 weeks, treatment every four weeks was linked to 73% higher odds of those expenses, while other family outcomes were similar. Support is needed throughout treatment, and less frequent dosing did not ease broader family strain.
- Journal
- Journal of the National Comprehensive Cancer Network : JNCCN (Q1)
- Published
- 1 October 2026
- Study design
- Randomized controlled trial
- Evidence level
- Level 1, High (CEBM 1b)
- Authors
- Rozalyn L Rodwin, John A Kairalla, Emily Hibbitts, Lyn M Balsamo, Meenakshi Devidas, Brenna Mossman, et al.
- PMID
- 42869069
- DOI
- 10.6004/jnccn.2026.7048
Why clinicians should know about it
- Picked for Hematology (top studies of the week, 25 October 2026): Family outcomes in B‑ALL maintenance regimen trial
Abstract
BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.