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Dapsone for paediatric chronic immune thrombocytopenia: Short report from a tertiary centre in South India
Niteesh Bharadwaj1, Jyothi Munireddy1, Sumithra Selvam2
1Pediatric Hematology Oncology, St John's Medical College Hospital, Bengaluru, Karnataka, India.
Insights
Dapsone effectively treats chronic immune thrombocytopenia (ITP) in children, showing good initial responses and sustained remission. This treatment offers a viable option for pediatric patients requiring second-line therapy.
Area of Science:
- Pediatric Hematology
- Immunology
- Pharmacology
Background:
- Immune thrombocytopenia (ITP) is an autoimmune disorder affecting platelet counts.
- While most childhood ITP cases resolve spontaneously, 10-20% develop chronic ITP requiring treatment.
- Second-line therapies are crucial for managing chronic pediatric ITP.
Purpose of the Study:
- To evaluate the efficacy and safety of dapsone as a single second-line agent for pediatric chronic ITP.
- To assess response rates and long-term outcomes in children treated with dapsone.
Main Methods:
- Retrospective analysis of 45 children with chronic ITP treated with dapsone between 2012 and 2016.
- Inclusion criteria ensured patients received dapsone as a single second-line agent.
- Data collected included demographics, early response, and long-term follow-up (median 50 months).
Main Results:
- An early response to dapsone was observed in 37.8% of pediatric patients.
- A sustained partial response was achieved in 64.4% of children during long-term follow-up.
- Dapsone demonstrated comparable efficacy to other available therapeutic agents.
Conclusions:
- Dapsone is an effective second-line treatment for pediatric chronic ITP.
- It provides favorable initial response rates and maintains remission in a significant proportion of children.
- Dapsone represents a valuable therapeutic option for this patient population.
Abstract:
Immune thrombocytopenia (ITP) resolves in most children within 3-12 months of diagnosis. Chronic ITP affects 10%-20% of patients, some of whom require treatment. Several second-line agents are efficacious in this group of patients. This paper describes our experience of using dapsone as a single second-line agent in children with chronic ITP. One hundred and three children with chronic ITP were seen at our centre from January 2012 to December 2016. Forty-five children met the inclusion criteria and received dapsone; 17 (37.8%) were boys; and 28 (62.2%) were girls. Early response to dapsone was seen in 37.8% of patients. The median duration of long-term follow-up was 50 months, and at least a partial response was seen in 64.4% of the patients. Dapsone offers good initial response rates and sustained remission in paediatric chronic ITP, comparable to other therapeutic agents available.
