IL6 and macrophage activation syndrome: To determine which patients were likely to develop hyper-inflammatory response, and therefore decide which patients should be given HDCPT, we mostly followed the criteria previously suggested from empirical observations and the guidelines used for the macrophage activation syndrome (IL-6 > = 40 pg/ml, and/or two of the following: D-dimer > = 1000 ng/ml, ferritin > = 300 ng/ml and triglycerides > = 300 mg/dL) [14].