Blood Res.  2017 Jun;52(2):95-99. 10.5045/br.2017.52.2.95.

Dapsone therapy for refractory immune thrombocytopenia patients: a case series

• Lee JY
• Lee JO
• Jung JY
• Bang SM

• KMID: 2413325
• DOI: http://doi.org/10.5045/br.2017.52.2.95

Abstract

BACKGROUND
Dapsone has been recommended as a second-line immunosuppressive agent for patients with immune thrombocytopenia (ITP).
METHODS
We retrospectively analyzed the efficacy and safety of dapsone therapy in patients with ITP.
RESULTS
Nine ITP patients were treated with dapsone at a dose of 50-100 mg/day between May 2013 and March 2016. All patients were refractory to multiple previous treatments, with a median of 7 agents (range, 4-8), and 3 patients had undergone a previous splenectomy. The median pre-treatment platelet count was 4×10⁹/L (range, 3-27×10⁹/L). Only 1 patient (11.1%) responded to dapsone therapy. No severe adverse events were observed, except for 1 case of dapsone hypersensitivity syndrome.
CONCLUSION
Although dapsone is still useful for some patients, it may be ineffective in heavily pretreated patients with profound thrombocytopenia.

Keyword

Immune thrombocytopenia; Dapsone; Efficacy; Toxicity

MeSH Terms

Dapsone*
Humans
Hypersensitivity
Platelet Count
Purpura, Thrombocytopenic, Idiopathic*
Retrospective Studies
Splenectomy
Thrombocytopenia
Dapsone

Figure

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  Fig. 1 Platelet count during dapsone treatment of (A) patient 2 and (B) patient 3.

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  Fig. 2 Clinical feature of a patient with dapsone hypersensitivity syndrome. (A) Skin erythema with extensive scaling on face and neck. (B) Multiple hypermetabolic lymph nodes in both neck and axilla, portocaval, celiac axis, retrocrural, both paraaortic, aortocaval, and both external iliac and inguinal areas.

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