Table 2

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