title: The Efficacy of Colchicine and Dapsone Combination Therapy in Relapsed Immune Thrombocytopenia.
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.
authors.affiliation: Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University , Chiang Mai, Thailand.
authors.forename: Thanawat
authors.initials: T
authors.lastname: Rattanathammethee
authors.affiliation: Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University , Chiang Mai, Thailand.
authors.forename: Wasan
authors.initials: W
authors.lastname: Theerajangkhaphichai
authors.affiliation: Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University , Chiang Mai, Thailand.
authors.forename: Ekarat
authors.initials: E
authors.lastname: Rattarittamrong
authors.affiliation: Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University , Chiang Mai, Thailand.
authors.forename: Sasinee
authors.initials: S
authors.lastname: Hantrakool
authors.affiliation: Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University , Chiang Mai, Thailand.
authors.forename: Chatree
authors.initials: C
authors.lastname: Chai-Adisaksopha
authors.affiliation: Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University , Chiang Mai, Thailand.
authors.forename: Lalita
authors.initials: L
authors.lastname: Norasetthada
authors.affiliation: Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University , Chiang Mai, Thailand.
authors.forename: Adisak
authors.initials: A
authors.lastname: Tantiworawit
keywords: Colchicine; Dapsone; Relapsed immune thrombocytopenia