Publication

Abstract : Background Idiopathic thrombocytopaenic purpura is an immune mediated disorder with enhanced platelet destruction in the reticulo-endothelial system. For chronic cases, various treatments are tried. Some patients tend to initially respond but eventually relapse. These medications are expensive and have side effects. Dapsone is an easily available, cheap and less toxic drug with a single daily oral dose. Aim To evaluate the response to dapsone in patients with chronic ITP. Methods Fifty patients with chronic ITP initiated on dapsone, in the hematology clinic were analyzed retrospectively. Six patients were excluded as they received steroids concomitantly. Patients with other etiologies for thrombocytopenia were excluded. Statistical analysis was done using the Stata 9.0 software. Results Total 44 patients were eligible for analysis. 26 (59.1%) were males and 18 (40.9%) females. All patients had received steroids earlier and 23 patients had received various other forms of therapy, before starting dapsone. Overall, 12 patients achieved a CR (27.3%) and R was seen in 9 (20.4%) patients. The observed median time to response was 3.5 months (range 1-6). Twenty three patients had received more than one form of therapy before dapsone and no statistically signifi cant difference was seen in patients who had received two or more therapies as compared to those who received only steroids (P = 0.62). Those who attained a CR had received dapsone at a mean dose of 1.9mg/kg/day (range 1-2.2), while those in the NR group received a mean dose of 2.05 mg/kg/day (range 1- 2.4), and the difference did not show any statistical signifi cance. No serious side effects, necessitating drug- withdrawal were observed in any of the patients. Conclusions Dapsone is effective in patients with chronic ITP. Prospective randomized controlled trials comparing dapsone with other forms of therapy, and larger sample size are warranted to corroborate these results.