Dapsone for Idiopathic Autoimmune Thrombocytopenic Purpura in Elderly Patients

Durand, J.-M.; Lefevre, P.; Hovette, P; Mongin, M; Soubeyrand, J.

doi:10.1111/j.1365-2141.1991.tb04467.x

Cited by 43 publications

(34 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Intensive consolidation chemotherapy for acute myeloid leukemia (AML) patients in complete remission is being increasingly administered on an outpatient basis. Although this approach has been found to be safe and feasible in younger patients [1][2][3][4][5][6], its safety in older patients remains unknown. We therefore undertook an evaluation of outpatient-based consolidation chemotherapy in older AML patients, and compared results to younger patients treated at the same institution over the same time period.…”

Section: Methodsmentioning

confidence: 99%

“…This agent is contraindicated in patients with G6PD deficiency and has a good safety profile. Hemolytic anemia and an increase of methemoglobin (MHb) are the main reported side effects [8,9].Previous studies highlighted the therapeutic activity of dapsone as salvage therapy in primary ITP with 40-60% overall response rate and 15-50% CR rate [1][2][3][4][5][6]. The response to dapsone was unaffected by pretreatment characteristics such as sex, age, platelet count, or duration of ITP and was generally treatment dependent, even if the persistence of response after dapsone discontinuation has been registered in some patients.…”

mentioning

confidence: 99%

“…

…”

mentioning

confidence: 99%

See 2 more Smart Citations

Dapsone salvage therapy for adult patients with immune thrombocytopenia relapsed or refractory to steroid and rituximab

et al. 2011

View full text Add to dashboard Cite

Dapsone is an antibacterial sulfonamide with anti-inflammatory property, which showed therapeutic activity in patients with immune thrombocytopenia (ITP) [1][2][3][4][5][6]; the activity in patients who showed refractoriness to rituximab is unknown. We evaluated the effect of dapsone in 20 consecutive adult patients, median age 51 years, with primary ITP previously treated at least with steroids and rituximab. Median baseline platelet count was 19 3 10 9 /L, and the median interval between diagnosis of ITP and dapsone therapy was 46 months. Response (platelet count 30 3 10 9 /L) and complete response (CR; platelet count 100 3 10 9 /L) were 55 and 20%, respectively; median time to response (TTR) was 1 month. All responders were able to interrupt any other specific anti-ITP treatment. The median duration of dapsone therapy in responders and the median response duration were 31 and 42 months, respectively. None of responders lost response during treatment. One patient in CR interrupted dapsone after 9 months and still maintained the response after 48 months. None of the patients interrupted the treatment for toxicity. All the patients were screened for normal glucose-6-phosphate-dehydrogenase (G6PD); two patients showed mild increase of methemoglobin (MHb). These results highlight the therapeutic activity and good safety profile of dapsone in patients with ITP who previously failed rituximab treatment. ITP is an acquired autoimmune disease characterized by increased platelet destruction, impaired megakaryocyte maturation with reduced platelet production, and possible hemorrhagic complications. Treatment is generally indicated for symptomatic patients, that is, those with active bleeding or very low platelet count (usually < 20-30 3 10 9 /L). Glucocorticoids, potentially associated with intravenous high-dose immunoglobulin in those cases with high risk of major bleeding, represent the standard first line of treatment [7]. However, despite the high initial therapeutic efficacy, in most cases, steroids tapering or withdrawal is followed by a drop in platelet count and the need for additional treatment. Treatment of patients with relapsed or refractory symptomatic ITP, particularly of those who are not eligible for, refused or failed splenectomy, still lacks a gold standard therapy. Dapsone is an antibacterial sulfonamide synthesized in 1908 with antimicrobial effect against leprosy, pneumocystic Jiroveci pneumonia in AIDS, toxoplamosis, and malaria. Since 1950s, dapsone also was recognized to have activity in a number of noninfectious inflammatory diseases of the skin as dermatitis herpetiformis and blistering disorders. The anti-inflammatory effect of dapsone is not fully understood, but it appears at least targeted against neutrophils, with interference of myeloperoxidase, inhibition of lysosomal enzymes, chemotaxis, and integrin-mediated adherence function. This agent is contraindicated in patients with G6PD deficiency and has a good safety profile. Hemolytic anemia and an increase of methemoglobin (MHb) are the ma...

show abstract

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

“…

…”

mentioning

confidence: 99%

See 1 more Smart Citation

Dapsone salvage therapy for adult patients with immune thrombocytopenia relapsed or refractory to steroid and rituximab

et al. 2011

View full text Add to dashboard Cite

show abstract

“…Three independent studies have demonstrated the effectiveness of dapsone (Durand et al, 1991;Godeau et al, 1993b;Hernandez et al, 1995). Although the number of patients was too small to identify correlations between their characteristics and the response to dapsone, and follow-up was too short to evaluate the long-term response, dapsone emerged as a simple and inexpensive therapy for chronic AITP.…”

mentioning

confidence: 99%

Dapsone for chronic autoimmune thrombocytopenic purpura: a report of 66 cases

Godeau¹,

Durand

Roudot‐Thoraval³

et al. 1997

Br J Haematol

View full text Add to dashboard Cite

Summary. Sixty-six adults with chronic autoimmune thrombocytopenic purpura AITP and platelet count <50 × 10 9 = l were treated with dapsone (75-100 mg orally). A response was observed in 33 patients. The median duration of treatment required to obtain a response was 21 d (range 8-90). The median maximal platelet count on treatment was 130 × 10 9 = l (range 71-355). Dapsone was continued in 20/33 responders for a median of 12 . 5 months (range 1-48) and the response persisted in 19. Treatment was intentionally withdrawn in the other 13 responders and thrombocytopenia immediately recurred in 12. Reversible side-effects required cessation of treatment in seven patients. These results demonstrate that dapsone is an effective, inexpensive, and well-tolerated treatment for chronic AITP.

show abstract

“…The best treatment for patients in whom splenectomy failed or is contraindicated remains debated. In these situations, three independent studies demonstrated that dapsone was a simple and inexpensive treatment that was effective in 50% of adults [1][2][3].…”

Section: Introductionmentioning

confidence: 99%

Lack of relevance of the acetylator status on dapsone response in chronic autoimmune thrombocytopenic purpura

Louët

Ruivart²,

Bierling

et al. 1999

Am. J. Hematol.

View full text Add to dashboard Cite

Dapsone provides an alternative treatment for patients with chronic autoimmune thrombocytopenic purpura (AITP) who had inadequate response to conventional therapy. However, the efficacy of this treatment is achieved in only 50% of patients. Dapsone is partly metabolized by the polymorphic N-acetyltransferase 2% and 50% of Caucasian patients show a genetically determined slow acetylator phenotype. The aim of our study was to investigate the influence of the acetylator status on dapsone efficacy in patients with chronic AITP. Nineteen caucasian adults with chronic AITP, previously treated by dapsone, were included in the study. Acetylator phenotype was determined by using a caffeine urinary test. Among the fourteen fast acetylator patients, eight patients exhibited positive response to dapsone and six patients did not. Among the five slow acetylator patients, one patient displayed a positive response to dapsone. Comparison of data by using the Fisher's exact test did not reach statistical significance. Our results do not support a relationship between dapsone efficacy and acetylator status in adults with chronic AITP. Am. J. Hematol. 62:251-252, 1999.

show abstract

Dapsone for Idiopathic Autoimmune Thrombocytopenic Purpura in Elderly Patients

Cited by 43 publications

References 5 publications

Dapsone salvage therapy for adult patients with immune thrombocytopenia relapsed or refractory to steroid and rituximab

Dapsone salvage therapy for adult patients with immune thrombocytopenia relapsed or refractory to steroid and rituximab

Dapsone for chronic autoimmune thrombocytopenic purpura: a report of 66 cases

Lack of relevance of the acetylator status on dapsone response in chronic autoimmune thrombocytopenic purpura

Contact Info

Product

Resources

About