INTRODUCTION:
Acute lymphoblastic leukemia(ALL), being the most prevalent malignancy
of childhood, has seen a barrage of treatment advances in the past few
years1. Better management has lead to improved
survival, which in turn has lead to an increased population of survivors
of ALL. India too has seen a fair share of improvement in survival of
children with ALL, ranging between 41-70%2. In the
current era , the treatment of ALL is most often done by chemotherapy.
Cranial irradiation is almost obsolete, restricted only to patients
presenting with central nervous system(CNS) positive disease. Targeted
therapy/bone marrow transplantation are considered only in certain high
risk groups. Pediatric oncologists all over the world are approaching a
more holistic approach to cancer care, of which survivorship is an
important component. Late effects are increasingly seen in survivors of
ALL, to the tune of almost 75%3. Among late effects,
neurocognitive deficits are extremely worrisome and significantly affect
the quality of life of the survivor and the family. Past studies which
have assessed neurocognitive deficits in survivors of acute leukemia
have found its prevalence to be around 38 to 58%4.
There are significant racial and ethnic variations in the biology of ALL
which may be translated into survivorship, an area that has not been
explored adequately, particularly in Low Middle Income Countries(LMIC).
Hence we conducted a study to evaluate the prevalence and spectrum of
neurocognitive deficits in survivors of childhood ALL, aged 6 to 17
years, who have completed treatment with documented remission of
at-least 2 years and to determine various factors associated with these
deficits.