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The efficacy of colchicine and dapsone combination therapy in relapsed immune thrombocytopenia

Thanawat Rattanathammethee, Wasan Theerajangkhaphichai, Ekarat Rattarittamrong, Sasinee Hantrakool, Chatree Chai-Adisaksopha, Lalita Norasetthada, Adisak Tantiworawit
  • Thanawat Rattanathammethee
    Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
  • Wasan Theerajangkhaphichai
    Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
  • Ekarat Rattarittamrong
    Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand | ekarat_r@hotmail.com
  • Sasinee Hantrakool
    Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
  • Chatree Chai-Adisaksopha
    Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
  • Lalita Norasetthada
    Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
  • Adisak Tantiworawit
    Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand

Abstract

The aim of the present paper is to evaluate the efficacy and safety of colchicine and dapsone combination therapy in cases of steroid-dependent, relapsed and refractory immune thrombocytopenia (ITP). This is a retrospective study of ITP patients who attended the Hematology Clinic at Chiang Mai University Hospital (Thailand) from 1 January 2008 to 30 September 2014. Medical records and clinical data were reviewed for efficacy and adverse effects. Sixty-four ITP patients received the combination therapy. The median age was 46 years and 70.3% were female. The majority (65.6%) were relapsed ITP patients. Median platelet count before starting treatment was 22.6×109/L. The response rate was 82.8%, with 75.0% of patients having a complete response. Median time to response was 8 weeks. The response rate was higher in relapsed patients (90.4%) compared to refractory (61.5%) and steroid-dependent patients (77.8%). Steroid treatment was discontinued in 30 patients (50%) following combination therapy. The most common side effect was hemolysis due to dapsone which was found in eight patients (12.5%). We can therefore conclude that combination therapy with colchicine and dapsone is an alternative second-line therapy option in relapsed ITP cases with acceptable side effects.

Keywords

Relapsed immune thrombocytopenia, Colchicine, Dapsone

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Submitted: 2017-01-09 13:52:18
Published: 2017-02-23 12:12:05
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Copyright (c) 2017 Thanawat Rattanathammethee, Wasan Theerajangkhaphichai, Ekarat Rattarittamrong, Sasinee Hantrakool, Chatree Chai-Adisaksopha, Lalita Norasetthada, Adisak Tantiworawit

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