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REVIEW article

Front. Oncol.

Sec. Pediatric Oncology

This article is part of the Research TopicExpanding the Horizons of Supportive Care in Pediatric Oncology: Integrating Physical Rehabilitation and NutritionView all articles

Behavioral Health Interventions for Pediatric Acute Lymphoblastic Leukemia: A Scoping Review

Provisionally accepted
Carolyn R, BatesCarolyn R, Bates1,2,3*Sydney M GibsonSydney M Gibson4Peter R JohnsonPeter R Johnson5Sarah L HuntSarah L Hunt6Patrick M DyjakPatrick M Dyjak4Courtney A GibsonCourtney A Gibson7Christina M SharkeyChristina M Sharkey8Kimberly KlagesKimberly Klages7
  • 1Department of Pediatrics, The University of Kansas Medical Center, Kansas City, United States
  • 2The University of Kansas Cancer Center Kansas City, Kansas City, United States
  • 3Center for Children's Healthy Lifestyles & Nutrition, Kansas City, United States
  • 4Kansas City University College of Osteopathic Medicine, Kansas City, United States
  • 5A. R. Dykes Library, The University of Kansas Medical Center, Kansas City, United States
  • 6The Catholic University of America, Washington, United States
  • 7Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, United States
  • 8Department of Psychology, The Catholic University of America, Washington, United States

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Background: Acute Lymphoblastic Leukemia (ALL) is the most common pediatric cancer, with significant advancements in treatment leading to over 90% five-year event-free survival rates in developed countries. However, disruptions in health behaviors during treatment, such as diet, activity, and sleep, can negatively impact treatment tolerance and increase risks of late effects. This scoping review aimed to assess the breadth of existing behavioral health interventions designed to improve immediate and long-term health outcomes for children and adolescents receiving treatment for ALL. Method: The review focused on behavioral interventions for children (ages 2-18 years) undergoing active treatment for ALL. We followed the JBI Manual of Evidence Synthesis and PRISMA-ScR guidelines, including a comprehensive search across PubMed, Elsevier, and Web of Science databases. Articles were screened, assessed, and data extracted by multiple reviewers to identify behavioral health promotion interventions used during ALL treatment. Results: A total of 157 full-text articles were screened, and 86 met inclusion criteria. Most interventions targeted physical activity and exercise (n=36), procedural distress (n=24), nutrition (n=8), and symptom reduction/management (n=6), with others targeting pain, sleep, and health-related quality of life. Date of publication, methodology, and behavioral intervention components varied considerably across studies. Conclusions: The literature on behavioral health promotion interventions during pediatric ALL treatment is broad but lacks depth, with many studies limited by small sample sizes and stalling at the feasibility stage. There is a need for larger, more rigorous trials to assess the effectiveness of these interventions and improve outcomes for youth with ALL.

Keywords: Acute Lymphoblastic Leukemia (ALL), pediatric, Health Behavior, behavioral intervention, behavioral health

Received: 02 Sep 2025; Accepted: 31 Oct 2025.

Copyright: © 2025 Bates, Gibson, Johnson, Hunt, Dyjak, Gibson, Sharkey and Klages. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Carolyn R, Bates, cbates4@kumc.edu

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

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