Most clinical studies addressing sequelae in children with leukaemia are not
theory-driven. Nonetheless, the role of different mediating biological (e.g. cranial
irradiation, chemotherapy) and psychosocial variables (e.g. family functioning) has
been empirically acknowledged. In these studies, a cause-effect relationship between
biological variables and cognitive deficits, sometimes complex due to multiple
agents, has been hypothesised. As for the psychosocial consequences, adaptation to
the cancer-related stress has been the main focus, at both the individual and family
levels. In this paper, we advocate the use of a global model for the development of
handicap, derived from the International Classification of Impairments, Disabilities
and Handicaps (ICIDH) by the World Health Organisation. This revised model proposes
that handicap is the result of complex interactions between the characteristics of a
person’s impairment, disabilities, and the characteristics of the
environment. At each of these levels, risk/resilience factors are defined. This
means that depending on the environmental obstacles they face, persons with an
impairment or a disability may or may not experience a situation creating a handicap
which is no longer seen as a stable status resulting from a disease to which the
individual must adapt. By reviewing animal and clinical studies, current knowledge
pertaining to leukaemia sequelae are integrated into the different levels defined by
the model: organic impairment, disabilities, environmental obstacles, and handicap
situation. Practical implications for research, policies, and individual treatments,
and comparisons with existing models, are also outlined.
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