[Treatment of idiopathic thrombocytopenic purpura with danazol].

PURPOSE

To assess the response to danazol in our patient population with ITP.

PATIENTS AND METHODS

We evaluated 17 patients with ITP (11 women and 6 men) with average age 67.3 +/- 9.9 years (range 46-83): 10 patients with acute ITP without response to corticosteroids during 4-6 weeks; 4 patients with acute ITP without treatment; 2 patients with chronic ITP and 1 patient with recurrent ITP resistant to corticosteroids. The dose of danazol ranged between 100 and 600 mg/d. The patients were included in two groups: 1) Responders if they achieved complete or partial remission; 2) Non-responders if they achieved transient or fair response.

RESULTS

The overall response rate was 58.8% and in patients previously treated 46.1%. The time to response was 35.6 +/- 48.5 days (range 14-180 days). Among the 10 responder patients 6 have remained in remission, 1 died 6 months after the remission for unrelated disease, and 3 relapsed after discontinuation of treatment with a good response after the reinstitution of therapy. Two patients resistant to treatment with danazol were splenectomized with transient response, and they responded favorably to the reinstitution of danazol. The treatment had a good tolerance.

CONCLUSION

1. The treatment with danazol in ITP is a good alternative therapeutical approach as initial treatment in ITP and ITP patients without response to corticosteroids. 2) ITP patients resistant to danazol may response to this treatment after splenectomy.