161 Leptin, hunger and fat 5 Table 1. Baseline characteristics Age (years) Median (range) 5.3 (3.0 ; 18.8) Sex n (%) Boy Girl 64 (61) 41 (39) Type ALL n (%) B-cell 93 (89) T-cell 11 (10) BPDCN 1 (1) CNS involvement n (%) Yes 20 (19) No 85 (81) Maintenance week Mean (SD) 35 (14) Abbreviations: n: number, ALL: acute lymphoblastic leukemia, BPDCN: blastic plasmacytoid dendritic cell neoplasm, CNS: central nervous system, SD: standard deviation Changes after five days of dexamethasone At T1, before the start of a five-day dexamethasone course, mean leptin SDS was -0.09 (±2.1), which increased to 1.8 (±1.5) (p<0.001) at T2 (Table 2, Figure 4A, Supplemental Figure 1). Fat mass increased significantly as well, from 5.1kg (IQR 3.8 to 8.5) at T1 to 5.6kg (IQR 4.3 to 9.6) at T2 (p<0.001) (Figure 4B), whereas BMI remained stable (17.3 kg/m2 (IQR 16.3 to 19.1) at T1 to 17.7 kg/m2 (IQR 16.5 to 19.0) at T2 (p=0.112) (Figure 4C). The median hunger scores at T1 were 5 (IQR 3 to 6) for average hunger, 6 (IQR 5 to 7) for most hunger, 2 (IQR 0 to 4) for least hunger and 5 (IQR 2 to 6) for fasting hunger. All hunger scores had increased significantly (p<0.001) at T2 to 7 (IQR 6 to 8), 8 (IQR 7 to 10), 4 (IQR 2 to 6) and 7 (IQR 5 to 9), respectively (Figure 4D). Median fatigue SDS was -0.5 (IQR -2.2 to 0.5) at T1, which decreased to -3.5 (IQR -4.6 to -2.0) at T2, indicating a significant increase in fatigue (p<0.001) (Figure 4E). The SDSC Total sleep score increased from 37 (IQR 32 to 46) at T1 to 48 (38 to 59) at T2 (p<0.001) (Figure 4F), indicating significantly more sleep problems. Sleep duration, based on the first question of the SDSC, decreased in 42 (40%) of patients, whereas in 62 (60%) sleep duration stayed the same or increased at T2.
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