BACKGROUND - With improving survival in acute lymphoblastic leukemia (ALL), now the focus is on late effects of therapy. Among these, neurocognitive deficits are the most worrisome. The objective of the study was to determine prevalence, spectrum and various factors associated with neurocognitive deficits in survivors of ALL aged 6 to 17 years.

DESIGN – An observational, cross-sectional study including 70 children. The neurocognitive functions were assessed by Indian adaptation of Wechsler intelligence scale for children-IV (WISC-IV).

RESULTS - The prevalence (95% confidence interval) of neurocognitive deficits in the sample population was 50% (38% - 62%). The prevalence (95% confidence interval) of deficits in the sample population in verbal comprehension was 49% (37% - 60%), in perceptual reasoning was 50% (38% - 62%), in working memory was 47% (35% - 59%) and in processing speed was 44% (32% - 56%). Lower socioeconomic status, poorer maternal & paternal education and higher birth order were associated with increased prevalence of neurocognitive deficits in the sample population. Gender, age at assessment and initiation of treatment, number of siblings,  family type, presence of CNS disease at diagnosis and type of chemotherapy protocol used were not statistically significant. Children with neurocognitive deficits had poorer nutrition status at the time of initiation of therapy  and at the time of assessment.

CONCLUSION - The prevalence of neurocognitive deficits in the survivors of childhood ALL was high 50%. Only 26% children had normal scores in all 4 domains. Prevalence of deficits was highest in perceptual reasoning.