111 Study protocol 3 that mainly patients who experience dexamethasone-induced neurobehavioral problems are motivated to participate in the trial. This could result in too few children without neurobehavioral problems and this may affect the study of possible determinants of dexamethasone-induced side effects. To investigate the presence of possible bias, we ask non-responders to fill in a short non-obligatory questionnaire with questions regarding dexamethasone-induced side effects. This allows for comparison between participants and non-participants. If too few patients are included in the Identification study when we reach 50 patients in the RCT, it may be possible to continue the Identification study to generate a larger group to answer our secondary research questions by amending the protocol. In conclusion, this study is set up to establish whether hydrocortisone addition to standard dexamethasone treatment is an effective therapy for dexamethasone-induced serious neurobehavioral side effects. With this therapy we aim to improve health related quality of life for ALL patients who suffer from this side effect during their 1.5 year treatment schedule.
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