Research Article

Use of dapsone in chronic/refractory immune thrombocytopenic patients: A single center experience

Volume: 5 Number: 2 April 29, 2023
EN

Use of dapsone in chronic/refractory immune thrombocytopenic patients: A single center experience

Abstract

Background: Dapsone is a second-line therapy for immune thrombocytopenia (ITP). It is cost-effective, with a response rate comparable to other drugs used as second-line therapy, such as azathioprine, danazol, cyclophosphamide, cyclosporine, vincristine, rituximab, and eltrombopag. Material and Methods: This retrospective study analyzed ten adult patients who presented to our hematology division outpatient clinic between March 2013 and July 2021, was diagnosed with chronic/refractory ITP, did not respond to first-line therapy, and used dapsone. Results: Eight (80%) patients were female, and 2 (20%) were male. The median age was 50 (range, 24-64) years. The mean pre-treatment platelet value was 12.8x109/L (range: 4-22.1x109/L). The median duration of symptoms before dapsone treatment was 60 (6-360) months. The median number of treatments received before dapsone was 4 (range: 3-6). All patients were routinely treated with oral dapsone 50 mg for two weeks, followed by 100 mg. The median time to treatment response was 39 (range: 14-90) days. The response rate was 60% (complete response 40%, partial response 20%). Asymptomatic anemia was observed as a side effect in only one patient. Conclusions: Based on these results, it can be speculated that dapsone is an effective, inexpensive, and well tolerated treatment option. Considering the economic status of developing countries, it seems very attractive to use dapsone as the second-line therapy for chronic/refractory ITP. To the best of our knowledge, this is the first study in Turkey on the use of dapsone for chronic/refractory ITP.

Keywords

Supporting Institution

uludag university medicine faculty

References

  1. Rodeghiero F, Stasi R, Gernsheimer T, Michel M, Provan D, Arnold DM, Bussel JB, Cines DB, Chong BH, Cooper N, Godeau B, Lechner K, Mazzucconi MG, McMillan R, Sanz MA, Imbach P, Blanchette V, Kühne T, Ruggeri M, George JN. Standardization of terminology, definitions and outcome criteria in immune thrombocytopenic purpura of adults and children: report from an international working group. Blood. 2009 Mar 12;113(11):2386-93. doi: 10.1182/blood-2008-07-162503.
  2. George JN, Woolf SH, Raskob GE, Wasser JS, Aledort LM, Ballem PJ, Blanchette VS, Bussel JB, Cines DB, Kelton JG, Lichtin AE, McMillan R, Okerbloom JA, Regan DH, Warrier I. Idiopathic thrombocytopenic purpura: a practice guideline developed by explicit methods for the American Society of Hematology. Blood. 1996 Jul 1;88(1):3-40.
  3. Neunert CE. Current management of immune thrombocytopenia. Hematology Am Soc Hematol Educ Program. 2013;2013:276-82. doi: 10.1182/asheducation-2013.1.276.
  4. Arnold DM. Second-line and subsequent therapies for immune thrombocytopenia (ITP) in adults. UpToDate 2023, Apr 21, 2022. Wolters Kluwer. https://www.uptodate.com/contents/second-line-and-subsequent-therapies-for-immune-thrombocytopenia-itp-in-adults. Accessed on 14 September 2022.
  5. Godeau B, Oksenhendler E, Bierling P. Dapsone for autoimmune thrombocytopenic purpura. Am J Hematol. 1993 Sep;44(1):70-2. doi: 10.1002/ajh.2830440117.
  6. Godeau B, Durand JM, Roudot-Thoraval F, Tennezé A, Oksenhendler E, Kaplanski G, Schaeffer A, Bierling P. Dapsone for chronic autoimmune thrombocytopenic purpura: a report of 66 cases. Br J Haematol. 1997 May;97(2):336-9. doi: 10.1046/j.1365-2141.1997.412687.x.
  7. Dutta TK, Goel A, Ghotekar LH, Hamide A, Badhe BA, Basu D. Dapsone in treatment of chronic idiopathic thrombocytopenic purpura in adults. J Assoc Physicians India. 2001 Apr;49:421-5.
  8. Hill QA. How does dapsone work in immune thrombocytopenia? Implications for dosing. Blood. 2015 Jun 4;125(23):3666-8. doi: 10.1182/blood-2015-03-632000.

Details

APA
Candar, Ö., Ozkocaman, V., Ersal, T., Zor Turna, T., Pınar, İ. E., Yalçın, C., Orhan, B., Çubukçu, S., Güllü Koca, T., Ali, R., & Özkalemkaş, F. (2023). Use of dapsone in chronic/refractory immune thrombocytopenic patients: A single center experience. Turkish Journal of Internal Medicine, 5(2), 70-76. https://doi.org/10.46310/tjim.1211506
AMA
1.Candar Ö, Ozkocaman V, Ersal T, et al. Use of dapsone in chronic/refractory immune thrombocytopenic patients: A single center experience. Turk J Int Med. 2023;5(2):70-76. doi:10.46310/tjim.1211506
Chicago
Candar, Ömer, Vildan Ozkocaman, Tuba Ersal, et al. 2023. “Use of Dapsone in Chronic Refractory Immune Thrombocytopenic Patients: A Single Center Experience”. Turkish Journal of Internal Medicine 5 (2): 70-76. https://doi.org/10.46310/tjim.1211506.
EndNote
Candar Ö, Ozkocaman V, Ersal T, Zor Turna T, Pınar İE, Yalçın C, Orhan B, Çubukçu S, Güllü Koca T, Ali R, Özkalemkaş F (April 1, 2023) Use of dapsone in chronic/refractory immune thrombocytopenic patients: A single center experience. Turkish Journal of Internal Medicine 5 2 70–76.
IEEE
[1]Ö. Candar et al., “Use of dapsone in chronic/refractory immune thrombocytopenic patients: A single center experience”, Turk J Int Med, vol. 5, no. 2, pp. 70–76, Apr. 2023, doi: 10.46310/tjim.1211506.
ISNAD
Candar, Ömer - Ozkocaman, Vildan - Ersal, Tuba - Zor Turna, Tuğçe - Pınar, İbrahim Ethem - Yalçın, Cumali - Orhan, Bedrettin et al. “Use of Dapsone in Chronic Refractory Immune Thrombocytopenic Patients: A Single Center Experience”. Turkish Journal of Internal Medicine 5/2 (April 1, 2023): 70-76. https://doi.org/10.46310/tjim.1211506.
JAMA
1.Candar Ö, Ozkocaman V, Ersal T, Zor Turna T, Pınar İE, Yalçın C, Orhan B, Çubukçu S, Güllü Koca T, Ali R, Özkalemkaş F. Use of dapsone in chronic/refractory immune thrombocytopenic patients: A single center experience. Turk J Int Med. 2023;5:70–76.
MLA
Candar, Ömer, et al. “Use of Dapsone in Chronic Refractory Immune Thrombocytopenic Patients: A Single Center Experience”. Turkish Journal of Internal Medicine, vol. 5, no. 2, Apr. 2023, pp. 70-76, doi:10.46310/tjim.1211506.
Vancouver
1.Ömer Candar, Vildan Ozkocaman, Tuba Ersal, Tuğçe Zor Turna, İbrahim Ethem Pınar, Cumali Yalçın, Bedrettin Orhan, Sinem Çubukçu, Tuba Güllü Koca, Rıdvan Ali, Fahir Özkalemkaş. Use of dapsone in chronic/refractory immune thrombocytopenic patients: A single center experience. Turk J Int Med. 2023 Apr. 1;5(2):70-6. doi:10.46310/tjim.1211506

30994   34277 29166

 

Turkish Journal of Internal Medicine, hosted by DERGİPARK, is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

by-nc-nd.png