Children with average-risk acute lymphoblastic leukemia (AR-ALL) are more likely to experience impaired physical and emotional functioning impairment compared with population norms, according to a prospective cohort study involving 594 individuals. Participants were ≥4 years of age when diagnosed with AR-ALL. Parents completed PedsQL4.0 and McMaster Family Assessment Device instruments. Investigators looked at impairment patterns and predictors. Among the results:

• At 2 months, 37% had impaired scores for physical functioning, and 26% had such for emotional functioning (vs population norms of ~2%).
• These elevations continued 2 years later.
• Patients with emotional impairment at 2 months had more than 3-fold higher odds of also having such 2 years later.
• Patients who experienced unhealthy family functioning were 50% more likely to have emotional impairment after controlling for age and gender.

The authors noted that early screening can help select patients who might benefit from family-based interventions.