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This study examined the relationship between parental distress and children's HRQoL, focusing on preschool\u2010aged children and toddlers. The aims were: to assess changes in children's HRQoL over time, compare HRQoL between children with ALL and healthy children, and evaluate the longitudinal association between parental distress and children's HRQoL.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The sample consisted of 46 parents of children with ALL, 58 parents of healthy children, and their children. Assessments were conducted in the first week of three treatment phases, (T0\u2010Consolidation; T1\u2010Intensification; T2\u2010Maintenance). Linear mixed models and Mann\u2010Whitney <jats:bold>U<\/jats:bold> tests were performed. Results revealed significant improvements in children's HRQoL over time, although lower than the healthy group. Parental psychological morbidity was associated with children's HRQoL at T1 but not at T2. Traumatic stress symptoms showed no association with children's HRQoL.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>These findings underscore the importance of targeting parental psychological morbidity (anxiety and depression symptoms) during more intensive treatment phases. Incorporating family\u2010centered care strategies that address parents' psychological morbidity can promote better outcomes for both children and parents, supporting adaptation during this challenging period.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pon.70207","type":"journal-article","created":{"date-parts":[[2025,7,5]],"date-time":"2025-07-05T01:53:22Z","timestamp":1751680402000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["The Role of Parental Distress in Children's Health\u2010Related Quality of Life in Pediatric Acute Lymphoblastic Leukemia"],"prefix":"10.1002","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9318-0511","authenticated-orcid":false,"given":"Ana","family":"Ferraz","sequence":"first","affiliation":[{"name":"Psychology Research Centre (CIPsi) School of Psychology University of Minho  Braga Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susana","family":"Faria","sequence":"additional","affiliation":[{"name":"Department of Mathematics Centre of Mathematics (CMAT) University of Minho  Braga Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M\u00f3nica","family":"Jer\u00f3nimo","sequence":"additional","affiliation":[{"name":"Pediatric Oncology Department Centro Hospitalar e Universit\u00e1rio de Coimbra Hospital Pedi\u00e1trico  Coimbra Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7987-2562","authenticated-orcid":false,"given":"M. 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