Factors influencing health-related quality of life in children with leukemia in Saudi Arabia: a cross- sectional study

Abstract

Abstract Background/objective Leukemia and its treatment can substantially impair children’s health-related quality of life (HRQoL). This descriptive cross-sectional study aimed to evaluate HRQoL among Saudi children with leukemia and to identify the demographic, clinical, and functional factors associated with HRQoL. Methods Eighty-six children aged 5–14 years with acute lymphoblastic or acute myeloid leukemia (AML) who were receiving active treatment at King Faisal Specialist Hospital and Research Center Riyadh, Saudi Arabia. All participants had been diagnosed at least three months before enrolment and were receiving active treatment. HRQoL was assessed using the Arabic version of the Pediatric Quality of Life Inventory™ (PedsQL™) 3.0 Cancer Module, while physical function was evaluated using the Quick Disabilities of the Arm, Shoulder and Hand (Quick-DASH) questionnaire and the Lower Extremity Functional Scale (LEFS). Correlations and theory-driven multiple linear regression analyses were performed to identify factors associated with HRQoL. Results The mean overall HRQoL score was 62.7 ± 16.5, indicating a moderate level of HRQoL. The lowest scores were observed for procedural anxiety, whereas communication had the highest domain score. Girls demonstrated significantly higher HRQoL than boys.Multiple linear regression identified female gender (β = 0.270, 95% CI: 4.457–13.241, p < 0.001), older age (β = 0.229, 95% CI: 1.951–7.986, p = 0.002), higher educational level (β = 0.239, 95% CI: 1.933–7.437, p = 0.001), and better lower-extremity function measured by the LEFS (β = 0.307, 95% CI: 0.142–0.434, p < 0.001) as significant positive predictors of higher HRQoL, whereas more intensive cancer therapy was independently associated with lower HRQoL (β = −0.211, 95% CI: −8.808 to − 1.922, p = 0.003). The model explained 70.1% of the variance in HRQoL (R² = 0.701; adjusted R² = 0.665; F(9,76) = 19.753, p < 0.001). Conclusions HRQoL in children with leukemia was independently associated with physical function, cancer treatment, and several sociodemographic characteristics. These findings highlight the importance of incorporating functional assessment and multidisciplinary supportive care into the management of children with leukemia to optimize HRQoL.