158 Chapter 5 T1 ALL MR patients T2 Questionnaires - ET - SDSC - PedsQL-MFS Time (days) 5 Dexamethasone 6mg/m2 Leptin Fat mass Figure 2. Study Design Acute lymphoblastic leukemia patients were included during maintenance therapy. Assessments took place before (T1) and after (T2) a five-day dexamethasone course. Leptin and fat mass were measured and parents completed three questionnaires on both timepoints. Abbreviations: ALL: acute lymphoblastic leukemia, MR: medium risk, ET: eating thermometer (hunger scores), SDSC: sleep disturbance scale for children, PedsQL-MFS: Pediatric Quality of Life Inventory – Multidimensional Fatigue Scale. We used the parent-reported validated Sleep Disturbance Scale for Children (SDSC) to assess sleep. The SDSC contains 26 items which combined generate a total sleep score: a higher score represents more sleep problems.24 Furthermore we used the first item of the SDSC to explore whether children slept more/the same or less during a dexamethasone course. This question asks parents to indicate how many hours their child slept on average per night the last week: 9-11 hours, 8-9 hours, 7-8 hours, 5-7 hours or less than 5 hours. Fat mass Total body fat mass (kg) was estimated using a multi-frequency segmental bioelectrical impedance analyzer (BIA) (Tanita MC-780, Tanita Corporation, Tokyo, Japan). Unadjusted values were reported since no normative values for fat mass are available for Dutch children under the age of five. Leptin Serum, from peripheral blood samples obtained on T1 and T2, was stored at -80°C and leptin levels were assessed all together after study closure to avoid variability in laboratory conditions. Leptin was quantified by ELISA (Mediagnost E07, Mediagnost, Tübingen, Germany) in an ISO15189 accredited laboratory. Kit controls were within range for all measurements.
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