Psychosocial Health Challenges of Siblings of Children with Leukemia: A Systematic Review

Abstract

Context: Childhood leukemia affects not only the diagnosed child but also the entire family, particularly siblings, who often experience a range of psychological, social, and emotional challenges. These challenges may adversely affect siblings’ mental health and overall quality of life over time. Evidence Acquisition: In this systematic review, 86 studies were initially deemed eligible; however, after full-text screening, 19 articles met the final inclusion criteria, synthesizing findings from 19 eligible studies published between January 2010 and June 2025. PubMed, Scopus, Web of Science, CINAHL, PsycINFO, Embase, and SID were comprehensively searched using predefined keywords. The inclusion criteria focused on studies that directly examined the psychosocial experiences of siblings of affected children. Data extraction was conducted independently by two reviewers to ensure reliability, and methodological quality was critically appraised using the Cochrane Risk of Bias Tool, the Newcastle-Ottawa Scale, and the Critical Appraisal Skills Programme Checklist. Quantitative and qualitative data were integrated using a thematic synthesis approach to provide a comprehensive understanding of recurrent psychosocial challenges and emerging patterns. This systematic review was registered in PROSPERO (CRD420251150690). Results: Twenty studies met the inclusion criteria. The evidence indicates that siblings of children with leukemia experience a range of challenges, including increased anxiety and depressive symptoms, feelings of neglect, early assumption of responsibilities, decreased academic performance, and strained family relationships. Factors influencing these outcomes include age, gender, family composition, illness duration, and availability of social support. Conclusions: The psychosocial difficulties experienced by siblings of children with leukemia warrant substantial attention within healthcare systems. Implementing targeted psychosocial support interventions may mitigate secondary adverse effects and improve overall family well-being. The findings of this review may inform clinical practice and policymaking in child and family mental health care. Future research should prioritize longitudinal and cross-cultural studies to clarify how siblings’ psychosocial challenges evolve over time and across contexts.