Dapsone therapy for refractory immune thrombocytopenia patients: a case series

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 4×10(9)/L (range, 3–27×10(9)/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.