I updated my Intuos4 driver to 6.1.5-3 from 6.1.2-5 and Blender 2.53 started crashing instantly on startup. Blender 2.49 worked fine as did Photoshop CS5.
I then tried 6.1.4-3 with the same results.
Uninstalling the Wacom software and going back to 6.1.2-5 fixed the problem, but it would be good if newer drivers could be used.
This is on Windows 7 64bit.