About

Kellee Parker, DO, MCR, is an Assistant Professor of Pediatrics at the University of Utah, specializing in Pediatric Hematology and Oncology within the Division of Pediatric Hematology/Oncology. She received her medical degree from Rocky Vista University and completed her Pediatric residency and Pediatric Hematology and Oncology Fellowship at Oregon Health & Science University. Additionally, she received advanced training in clinical research through the Masters in Clinical Research program at Oregon Health & Science University. Her clinical interests include the care of children with leukemia, lymphoma, and various other childhood cancers, as well as the long-term care of patients who have survived childhood cancer. Her research focuses on improving care for childhood cancer survivors and their families, as well as decision-making processes related to enrollment in clinical trials within pediatric oncology. Dr. Parker is a member of the Leukemia and Lymphoma team at the University of Utah and Primary Children’s Hospital, contributing to both clinical practice and research aimed at advancing pediatric cancer treatment and survivorship.

Research topics

• Medicine
• Psychiatry
• Family medicine
• Psychology
• Nursing
• Social psychology
• Clinical psychology
• Psychotherapist
• Pediatrics
• Internal medicine
• Pathology

Selected publications

• Characterizing Parental Concerns About Lasting Impacts of Treatment in Children With B‐Acute Lymphoblastic Leukemia

  Pediatric Blood & Cancer · 2026-01-23

  articleOpen access1st authorCorresponding

  BACKGROUND: B-acute lymphoblastic leukemia (B-ALL) is the most common pediatric cancer, and while most children in high-resource settings are cured, therapy carries risks for long-term toxicities. Understanding parents' concerns about these late effects is essential to guide anticipatory support and inform evolving therapeutic approaches. PROCEDURE: In partnership with the national patient advocacy organization, Momcology, parents of children diagnosed with ALL between the ages 1 and 19 years completed an online survey. Parents selected up to five concerning potential late effects, rated the level of intensity of concern, and provided open-text responses. Quantitative analyses examined associations with child and parent factors, and qualitative responses were analyzed using directed content analysis. RESULTS: The survey was completed by 442 parents of children with B-ALL. The most frequently cited concerns were neurocognitive deficits (55%), secondary cancers (49%), mental health changes (36%), cardiotoxicity (31%), and infertility (30%). Concern for neurocognitive deficits persisted during and after therapy and was of greater concern among parents of younger children compared with older children (58% vs. 41%; p = 0.006). Concerns about neurocognitive effects correlated with concern for mental health and social changes (RR 1.86, 95% CI 1.40-2.47, RR 1.43, 1.03-1.98). Open-text responses for all late effects of concern indicated enduring worry and impacts on family anxiety, daily life, and children's future opportunities. CONCLUSIONS: Parents of children with B-ALL report substantial, persistent concern about late effects, particularly neurocognitive impairment. Findings underscore the need for information and guidance for parents of children with ALL about late effects and the importance of integration of parent perspectives in defining ALL research priorities.

  PublisherOA PDFDOI

• Characterizing Difficulty and Life Disruption During B‐Acute Lymphoblastic Leukemia Therapy From the Perspective of Parents: A Survey Study

  Pediatric Blood & Cancer · 2025-09-08 · 5 citations

  articleOpen access1st authorCorresponding

  PURPOSE: Children with B-acute lymphoblastic leukemia (B-ALL) treated in resource-intensive settings have a high likelihood of cure, but therapy is long, burdensome, and associated with substantial toxicities. Understanding parents' perceptions of the most disruptive and difficult aspects of B-ALL treatment is critical to future improvements in care. We aimed to understand which child side effects, chemotherapeutic agents, and aspects of leukemia care are rated difficult or disruptive by parents, and variations based on parent or child characteristics. METHODS: Parents of children (1-19 years) currently or previously treated for B-ALL who are members of the Momcology pediatric cancer support and advocacy organization were invited to complete an online survey on difficult and disruptive aspects associated with their child's diagnosis. Data were analyzed descriptively, and inferential statistical tests evaluated characteristic-based differences. RESULTS: Parents of 442 children completed the survey. Nausea/vomiting was the most commonly reported difficult side effect during pre-maintenance therapy (55.4%), followed by decreased energy (41.4%) and neuropathy (40.7%). Mood changes were the most difficult side effect during maintenance therapy (29.3%). The extent of difficulty associated with each side effect reported was high. Most parents (79.6%) rated oral corticosteroids as the most difficult chemotherapeutic agent. The components of care most difficult and disruptive were unplanned hospital visits (79.9%) and compromised immunity (76.9%). Parent-rated difficulties significantly varied by child age at diagnosis. CONCLUSIONS: Parents of children with B-ALL report substantial child and family difficulties that are directly attributable to leukemia treatment. These findings should inform areas of investigation for optimizing treatment regimens and supportive care.

  PublisherOA PDFDOI

• Identifying clustering in patterns of late effects among survivors of adolescent and young adult Hodgkin lymphoma

  JNCI Cancer Spectrum · 2025-09-27

  articleOpen access1st authorCorresponding

  BACKGROUND: We examined late effects clustering among adolescent and young adult (AYA; age 15-39 years at diagnosis) Hodgkin lymphoma (HL) survivors and identified characteristics associated with each cluster. METHODS: We included AYAs with HL in 2006-2018 from the California and Utah Cancer Registries linked to statewide hospitalization, emergency department, and ambulatory surgery visit data. We identified severe late effects >2 years after cancer diagnosis in 9 late effects categories. Latent class analysis (LCA) was used to identify late effects clusters. Multinomial logistic regression models estimated adjusted associations of demographic and treatment characteristics with LCA late effect group. RESULTS: We identified 4635 AYA HL survivors with median follow-up of 8.2 years and 4 late effects groups: 77.1% had a low probability of any late effect (Low Morbidity), 12.8% had high probability of Thyroid disorders, 8.0% had high probability of Cardiovascular Disease (CVD), and 2.1% had high probability of Multiple Conditions (CVD, diabetes/pancreatic, thyroid, and renal diseases). Publicly insured AYAs were more likely than those with private insurance to be in the CVD (OR = 1.53, 95% CI = 1.18 to 1.98) and Multiple Conditions (OR = 2.17, 95% CI = 1.29 to 3.66) than the Low Morbidity group. AYAs with radiation were more likely to be in the Multiple Conditions (OR = 2.31, 95% CI = 1.41 to 3.78) and Thyroid (OR = 2.81, 95% CI = 2.20 to 3.58) groups. Hematopoietic cell transplantation was associated with Multiple Conditions (OR = 9.50, 95% CI = 5.82 to 15.50), CVD (OR = 3.82, 95% CI = 2.96 to 4.93), and Thyroid (OR = 2.86, 95% CI = 2.12 to 3.85) groups. CONCLUSIONS: While most AYA HL survivors were in the Low Morbidity group, those with public insurance or intense treatment may be at higher risk for multiple conditions.

  PublisherDOI

• Patient and Family Caregiver Perspectives on Therapy De‐Escalation in Cancer: A Scoping Review

  Psycho-Oncology · 2025-02-01 · 3 citations

  reviewOpen access

  BACKGROUND: Cancer therapy de-escalation aims to reduce treatment intensity, minimizing the burden of short- and long-term toxicities on patients and family caregivers while maintaining current survival rates. While this approach holds potential benefits, it comes at a risk of worse patient health outcomes or treatment failure. An understanding of patient and family caregiver perspectives regarding cancer therapy de-escalation is required to design successful patient-and-caregiver-informed clinical trials, and optimally provide related patient-centered care. AIM: To identify and synthesize the literature about patient and family caregiver perspectives of cancer therapy de-escalation to guide clinical care, research, decision-support resources, and education. METHODS: Following the Joanna Briggs Institute methodology, a systematic literature search was conducted in MEDLINE, EMBASE, PsycINFO, and CINAHL. We included quantitative, qualitative, and mixed-methods studies involving patients of all ages and cancer diagnoses and their family caregivers that focused on perceptions of cancer therapy de-escalation. Extracted data were organized according to the Framework for De-implementation in Cancer Care Delivery. Study quality was appraised. RESULTS: Twenty studies were included. De-escalation perspectives varied between patients and family caregivers, with factors including clinician trust and desire to improve quality of life noted as influential in de-escalation decisions. The decision-making process could be better supported through the provision of timely patient and family caregiver information and clinician communication training. CONCLUSION: Cancer therapy de-escalation decisions are complex and multifactorial. Future research exploring which factors influence patient and family decision-making may offer insight into the design of optimal informational and supportive interventions.

  PublisherOA PDFDOI

• Palliative and End-of-Life Disparities for Pediatric Hispanic, Spanish-preferring Patients With Cancer

  Journal of Pediatric Hematology/Oncology · 2025-03-21 · 3 citations

  articleCorresponding

  The influence of ethnicity and language preference on palliative and end-of-life (EOL) experiences in children with cancer is poorly understood. Existing data relies on adult studies and suggests that patients from underserved populations often receive inferior palliative and EOL care, characterized by medically intense care at EOL. This qualitative study explores the EOL experiences of English and Spanish-preferring families of children with poor-prognosis cancers, with the hypothesis that language-based disparities exist. English and Spanish-preferring parents of children with poor-prognosis cancers, and bereaved parents whose children died of cancer within the last 5 years were eligible. Language preference and ethnicity data were obtained from the patient chart and confirmed by self-report during interviews. We conducted 11 interviews with 15 caregivers: 6 in Spanish and 5 in English. Interviews were recorded, transcribed, and analyzed using Braun and Clarke inductive coding approach. Our analysis revealed that many Hispanic, particularly Spanish-preferring families, reported disparities compared with non-Hispanic families, including inconsistent interpreter use, confusion about prognosis and treatment, perceived discrimination, inadequate EOL anticipatory guidance, and dissatisfaction with hospice. The study identifies perceived gaps in our current practices that negatively impact pediatric Hispanic, Spanish-preferring patients and their families. Larger scale studies are needed to further explore the influence of language preference on EOL experiences. There is a critical need to better assess the effective delivery of pediatric palliative care among Spanish-preferring families, and interventions to reduce disparities in EOL/palliative care should be founded on the expressed needs of families who prefer to communicate in languages other than English.

  PublisherDOI

• The Impact of Structural and Meso-Level Factors on Caregiver Coping Abilities When Supporting a Child with Cancer: A Qualitative Study

  International Journal of Environmental Research and Public Health · 2024-07-11 · 1 citations

  articleOpen access

  Family caregivers of children diagnosed with cancer often experience periods of significant stress. We provide an in-depth examination of the impacts of structural (health care and leave policies) and meso-level (organizations and communities/social networks) factors on caregiver coping during childhood cancer treatment. We conducted a secondary analysis of a comprehensive qualitative dataset examining the impacts of structural and meso-level factors on caregiver coping from in-depth, semi-structured interviews with 49 caregivers representing 38 unique cases of childhood cancer. Using a modified grounded theory approach, transcripts were analyzed using inductive thematic analysis. Caregivers experienced multiple and often intersecting structural and meso-level factors, both facilitating and impeding their ability to cope during their child's cancer treatment. Our analysis revealed the following themes: having few out-of-pocket medical expenses, access to paid time off from employment, and support from one's health system, organizations, or community/social networks fostered caregiver coping. Significant financial burdens due to cancer treatment, having to take unpaid leave from employment, remaining employed regardless of one's circumstances, and lack of support from one's health system, organizations, or community/social networks hindered caregiver coping. Our findings point to several policies that may ease caregiver burden and facilitate caregiver coping during childhood cancer treatment.

  PublisherOA PDFDOI

• Risk Factors and Trends for HPV-Associated Subsequent Malignant Neoplasms among Adolescent and Young Adult Cancer Survivors

  Cancer Epidemiology Biomarkers & Prevention · 2023-04-18 · 4 citations

  articleOpen access

  BACKGROUND: Subsequent malignant neoplasms (SMN; new cancers that arise after an original diagnosis) contribute to premature mortality among adolescent and young adult (AYA) cancer survivors. Because of the high population prevalence of human papillomavirus (HPV) infection, we identify demographic and clinical risk factors for HPV-associated SMNs (HPV-SMN) among AYA cancer survivors in the SEER-9 registries diagnosed from 1976 to 2015. METHODS: Outcomes included any HPV-SMN, oropharyngeal-SMN, and cervical-SMN. Follow-up started 2 months after their original diagnosis. Standardized incidence ratios (SIR) compared risk between AYA survivors and general population. Age-period-cohort (APC) models examined trends over time. Fine and Gray's models identified therapy effects controlling for cancer and demographic confounders. RESULTS: Of 374,408 survivors, 1,369 had an HPV-SMN, occurring on average 5 years after first cancer. Compared with the general population, AYA survivors had 70% increased risk for any HPV-SMN [95% confidence interval (CI), 1.61-1.79] and 117% for oropharyngeal-SMN (95% CI, 2.00-2.35); cervical-SMN risk was generally lower in survivors (SIR, 0.85; 95% CI, 0.76-0.95), but Hispanic AYA survivors had a 8.4 significant increase in cervical-SMN (SIR, 1.46; 95% CI, 1.01-2.06). AYAs first diagnosed with Kaposi sarcoma, leukemia, Hodgkin, and non-Hodgkin lymphoma had increased HPV-SMN risks compared with the general population. Oropharyngeal-SMN incidence declined over time in APC models. Chemotherapy and radiation were associated with any HPV-SMN among survivors with first HPV-related cancers, but not associated among survivors whose first cancers were not HPV-related. CONCLUSIONS: HPV-SMN in AYA survivors are driven by oropharyngeal cancers despite temporal declines in oropharyngeal-SMN. Hispanic survivors are at risk for cervical-SMN relative to the general population. IMPACT: Encouraging HPV vaccination and cervical and oral cancer screenings may reduce HPV-SMN burden among AYA survivors.

  PublisherOA PDFDOI

• Hopping as an Indicator of Chemotoxicity: Gait Analysis in Patients With Leukemia and Lymphoma

  Journal of Pediatric Hematology/Oncology · 2023-02-23 · 1 citations

  article1st authorCorresponding

  BACKGROUND: Survivors of acute lymphoblastic leukemia (ALL) can experience chemotherapy-related changes in neuromuscular function, which can persist and impact the quality of life. Clinically, neuromuscular changes are assessed by observing gait. The primary aims of this study were to compare observational gait/functional movement analysis to matched electronic gait analysis in children with ALL and lymphoblastic lymphoma at specific time points during and after treatment. PATIENTS AND METHODS: Participants 2 to 27 years old diagnosed with ALL/lymphoblastic lymphoma who were on or off therapy within 10 years were eligible. Participants underwent electronic gait assessment using GAITRite, observational gait, and functional movement analysis and completed quality of life questionnaires. Parents also completed quality-of-life assessments. RESULTS: Electronic gait parameters were not different in this cohort compared with controls. Mean overall scores on observational gait and functional movement analysis improved over time. Hopping was the most frequent and walking was the least frequent noted deficit. Participants had a lower patient and parent-reported QoL scores compared with the general population. CONCLUSION: Observational gait and functional movement analysis identified more deficits than the electronic gait assessment. Future studies are warranted to determine whether hopping deficits are an early clinical indicator of toxicity and signal for intervention.

  PublisherDOI

• Family perspectives on the transition from active treatment to survivorship for children with cancer

  Pediatric Blood & Cancer · 2023-06-19 · 7 citations

  articleOpen access1st authorCorresponding

  BACKGROUND: Completing therapy for childhood cancer is an exciting milestone. However, this adjustment can be extremely stressful for patients and their families as they transition from cancer patient to survivor. A better understanding of the patient and family experience and their needs during this transition is crucial for developing guidelines and leveraging support for future patients and families. PROCEDURE: Participants were recruited from across the United States using a maximum variation sampling strategy. Families were eligible if they had a child diagnosed with cancer before age 15 and had completed treatment at least 1 year prior to their interview. Participants completed a 90-180-minute semi-structured interview either in person or virtually. Interviews focused on the experiences of getting a diagnosis, experiences with treatment, information seeking, impact of cancer on the family, social support, and transitions to survivorship. Inductive thematic analysis revealed a wide variety of themes. This paper examines the transition from active cancer therapy into survivorship. RESULTS: Identified primary themes included (i) feelings about transitioning off therapy; (ii) coping with lingering effects; and (iii) experiences of transitioning off therapy and survivorship care. Subthemes highlighted the need for more support for both patients and families during this transition. CONCLUSION: Patients and families desire more support during the transition off therapy. Suggestions included access to additional resources, earlier transition to receiving survivorship care, and more holistic survivorship care. Further research is needed to determine best models and feasibility of delivering this desired support to all patients and families.

  PublisherOA PDFDOI

• “The place it puts us in emotionally and relationally with our child, it’s damaging”: understanding the real-world psychosocial needs of caregivers of childhood cancer survivors

  Journal of Cancer Survivorship · 2023 · 5 citations

  • Medicine
  • Clinical psychology
  • Psychiatry
  PublisherOA PDFDOI

Frequent coauthors

• Heidi A. Hanson

  University of Utah

  24 shared

• Judy Y. Ou

  University of Utah

  22 shared

• Anne C. Kirchhoff

  20 shared

• Heydon K. Kaddas

  20 shared

• Joemy M. Ramsay

  University of Utah

  20 shared

• Deanna Kepka

  20 shared

• Douglas Fair

  University of Utah

  20 shared

• Echo L. Warner

  University of Utah

  20 shared

Labs

• University of Utah Pediatric Hematology & OncologyPI

Education

• DO

  Rocky Vista University College of Osteopathic Medicine

  2014

• Bachelor of Science

  University of Oregon

  2008