The role of danazol in the treatment of refractory idiopathic thrombocytopenic purpura. A report of 22 cases.

We treated 22 patients with refractory idiopathic autoimmune thrombocytopenic purpura (ITP) with Danazol (generic name). Median age was 57 (1 child aged 11, and 21 adults aged 18 to 77). Patients were refractory to or had contraindication to therapy by prednisone and splenectomy. Several patients had already received other treatments. All patients received Danazol at a daily dose of 600 mg/day for at least 2 months (except the child who received 400 mg/day), and other treatments for ITP were discontinued when Danazol was started. Two patients achieved complete remissions (CR), one partial remission (PR) and four had minor responses (MR). The remaining 15 patients had no response (NR). One of the complete responses lasted 34 months, but was dependent on daily maintenance doses of Danazol of 400 mg or more. One partial responder remained so after seven months, four months following the discontinuation of Danazol. All other responders relapsed within three months, while receiving Danazol 600 mg/day. The drug was generally well tolerated, with few side effects. Danazol, when used as a single drug in refractory ITP, therefore had limited benefit in our experience.