Objective:

To describe the end-of-life trajectory and medical care aggressiveness in patients with non-complete remission acute leukemia after allogeneic transplantation, and to explore parental distress during the transition to palliative care for children post-HSCT, emphasizing the relationship between these two aspects.

Key Findings:

• 84.8% of patients died during follow-up, with a median survival of 6.3 months.
• 59% of deaths were due to relapse; 86.5% died in inpatient settings.
• Parental distress was high, with a mean score of 7.9 on the Distress Thermometer, highlighting significant emotional and practical challenges.

Interpretation:

End-of-life care aggressiveness was consistent with existing literature, indicating a need for improved advance care planning and discussions about goals of care. The high levels of parental distress underscore the necessity for targeted psychosocial support during transitions to palliative care, including counseling and resources for families.

Limitations:

• Single-center study may limit generalizability of findings; results may not apply to broader populations.
• Small sample size in parental distress study may not represent the wider experience of families in similar situations.

Conclusion:

The studies underscore the importance of integrating palliative care early in treatment trajectories and addressing the psychosocial needs of families during critical transitions, advocating for systematic support mechanisms.