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Thirty children in remission, at least one year after completing chemotherapy for Acute Lymphoblastic Leukemia, were assessed using general psychological measures. The Wechsler Intelligence tests were administered to evaluate their intellectual function: no significant reduction was found in overall IQ score. Only four of the patients, who presented neurological complications during the treatment, performed at lower levels. The group as a whole functioned poorly on tasks involving speeded performances and long-term memory. The age at diagnosis, the duration of the illness, the cranial irradiation and/or intrathecal-chemotherapy did not show any negative effects on the intellectual performance. Psycho-social adaptation was satisfactory: our patients do not show neurotic or psychotic disorders, but only affective disturbances (insecurity, irritability, poor self-perception, instability and depression). Familial adaptation was disturbed in 60% of the children and difficulty in socializing with peers was present in 57% of cases: the latter, in our experience, is related to poor self perception, present in 75% of our patients. We have found a more inadequate psycho-social adaptation in children who have not received any communication of their illness. Psychologic support can be of value for the child and his family in adapting to their difficult situation and in promoting a normal personality development of the child.

145 children with acute lymphoblastic leukaemia (ALL) were evaluated over a period of 3 years in a multicentre study in which serial cranial computed tomographic (CT) scans of the brain were done. All patients were symptom-free. CT scans were graded as normal, borderline (slight or moderate cerebral atrophy), or pathological (severe cerebral atrophy). 62% (90/145) of children had CT scan abnormalities at diagnosis. After a median follow-up of 24 months (range 6-36) 12 of 108 evaluable patients had central nervous system (CNS) relapses (6 isolated relapses and 6 combined with relapse at another site). All patients with CNS relapse had an abnormal CT scan at diagnosis (8 pathological and 4 borderline). No relapses were observed among the 42 patients with a normal cranial CT scan at diagnosis. A significantly higher proportion of severe cerebral atrophy, both following CNS prophylaxis and after the discontinuation of treatment, was found among patients with a borderline CT scan at diagnosis than among patients with a normal CT scan at diagnosis. Thus an abnormal cranial CT scan at diagnosis in children with ALL seems to have prognostic significance.