Inclusion and exclusion criteria for ASCT in JIA
| Inclusion criteria | |
| 1. | Diagnosis of JIA according to ILAR criteria1 |
| 2. | Disease type systemic onset with polyarticular course, or polyarticular onset |
| 3. | Disease duration at least one year |
| 4. | Evidence of active inflammatory disease for at least six months by accepted criteria,45 but systemic patients must not have rash or high fever at time of treatment |
| 5. | Evidence of failure of, or toxicity from, standard therapy. Treatment failure includes patients whose disease is uncontrolled on: |
| High dose corticosteroids (>0.3 mg/kg) | |
| High dose methotrexate (1 mg/kg) given parenterally for three months | |
| Combination therapy of methotrexate and another drug, e.g. cyclosporin | |
| Patients with active disease under treatment with “Seattle protocol”46 for six months | |
| Anti-TNF treatment given at appropriate doses for six months | |
| Unacceptable toxicity includes: | |
| Corticosteroid toxicity, e.g. growth failure, osteoporosis with fractures, avascular necrosis, hypertension, cataract | |
| Unacceptable renal toxicity related to cyclosporin | |
| Unacceptable elevation in liver enzymes related to methotrexate | |
| Drug induced cytopenia | |
| 6. | Patient’s general condition must be such that the procedure of ASCT itself will not pose an undue risk |
| 7. | There is potential for improvement in functional disability |
| Exclusion criteria | |
| 1. | Severe chronic infection (particular caution with respect to TB) |
| 2. | Severe functional disability with no potential for improvement |
| 3. | Severe organ dysfunction (cardiac, respiratory, hepatic, renal) |
| 4. | Inadequate social factors |