ORLANDO, FL – December 7, 2025 – Financial hardship unfolds gradually for families navigating a child’s treatment for acute lymphoblastic leukemia (ALL), with nearly one in four families experiencing new material hardship even when starting treatment with adequate resources, according to research presented today at the 67th American Society of Hematology Annual Meeting & Exposition. The study underscores the need for ongoing financial screening adn support throughout the entirety of a child’s cancer therapy.
Researchers followed families participating in the DFCI ALL 16-001 Trial and found that at baseline, 115 out of 428 families (27%) reported household material hardship (HMH). Over the course of treatment, the cumulative incidence of any new HMH reached 19.3% at 6 months, 27.7% at 12 months, and 30.0% at 24 months (95% CI: 25.9-34.7). Similarly,catastrophic income loss affected 20.3% of families at 6 months, 28.6% at 12 months, and 31.5% at 12 months (95% CI: 27.2-36.5).
Among 307 families with no baseline HMH, 24.3% (95% CI, 19.9-29.6) developed new HMH and 27.9% (95% CI, 23.1-33.7) experienced catastrophic income loss by 24 months.
Specific factors increased the risk of developing new HMH during treatment. Families of children who identified as non-Hispanic Black (RR 3.5; 95% CI, 1.7-7.3),were living in a single-parent household (RR 2.1; 95% CI, 1.3-3.2), preferred a non-dominant language (RR 2.1; 95% CI, 1.2-3.6), or had baseline household income less than 200% federal poverty level (RR 1.8; 95% CI, 1.1-2.9) were significantly more likely to experience financial strain.
“By 24 months, 30% of families had experienced new HMH and 31.5% of families had experienced catastrophic income loss at some point during their child’s cancer therapy,” saeid Dr. David Zheng, lead researcher on the study. He noted that housing insecurity was a primary driver of the observed hardship.
Dr.Zheng emphasized the need for repeated financial assessments throughout treatment, stating, “This can’t be the type of thing where you meet a family at diagnosis, they get an initial screen, and then you just assume that the family is going to be fine for the subsequent 2 years.” He recommends benefits counseling and direct cash payments to address the diverse financial needs of families, particularly given the high survival rate for children with ALL-over 90% are expected to survive their cancer. He and his coauthors are currently conducting research on family-centered interventions to mitigate financial toxicity.
A 2020 Gallup poll cited in the research found that 50% of americans fear bankruptcy due to a major health event.
