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.