Hickman right atrial catheters are useful in providing prolonged access for chemotherapy. Their presence does alter body image, however, and the maintenance of catheter patency during periods of outpatient care demands patient cooperation and participation. To determine whether the alterations in body image and life-style brought about by catheter insertion would have a negative effect upon the self-esteem of patients with acute leukemia, "purpose-in-life" testing was done prospectively in two groups of patients treated over a 30-day period with and without right atrial catheters. No significant alterations in self-esteem were noted during the study period in response to the use of Hickman catheters. The results suggest that Hickman catheters can be used as needed to improve venous access in patients with acute leukemia, without fear that this will adversely affect self-esteem.