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Rheumatology 1999; 38: 739-742
© 1999 British Society for Rheumatology

Paediatric Rheumatology: Autologous Stem Cell Transplantation in Rheumatic Diseases of Childhood

Prognosis in children with rheumatic diseases: justification for consideration of new therapies

Series Editor: P. Woo

R. E. Petty

Division of Rheumatology, Department of Paediatrics, University of British Columbia, Vancouver, Canada and Division of Immunology, Department of Paediatrics, University of Utrecht, Utrecht, The Netherlands

Correspondence to: R. E. Petty, Division of Rheumatology, Department of Paediatrics, University of British Columbia, Vancouver, Canada and Division of Immunology, Department of Paediatrics, University of Utrecht, Utrecht, The Netherlands.

The introduction of any new therapy is based on dissatisfaction with the effectiveness or the side-effects of current therapy, i.e. the prognosis of the disease as it is currently treated. In order to determine the appropriateness of a new therapy such as autologous bone marrow transplantation (ABMT), it is important to have an understanding of the anticipated long-term prognosis of the diseases for which it is proposed. Although ABMT is being considered for a number of rheumatic diseases of childhood, the present discussion will focus on chronic arthritis. Three aspects will be considered:

  1. What are the difficulties in evaluating the outcome of a chronic disease such as juvenile rheumatoid arthritis (JRA)?
  2. What is the outcome of the diseases as currently treated?
  3. What are the disease or demographic characteristics that predict unfavourable outcome at disease onset?

Evaluating outcome

Studies of the outcome of systemic or polyarticular arthritis are few and fraught with difficulty . . . [Full Text of this Article]

What is meant by `outcome'?

Current outcome of chronic childhood arthritis

Mortality

Predictors of outcome

Summary

References


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