Haematologic changes associated with multidrug therapy in leprosy

Leprosy is a chronic infectious condition caused by Mycobacterium leprae, which predominantly involves the skin and peripheral nervous system. Multidrug therapy (MDT), consisting of dapsone, rifampicin, and clofazimine, remains the primary treatment. Although effective, MDT may induce haematologic changes, particularly due to the oxidative effects of dapsone. This study aimed to evaluate haematologic changes among leprosy patients receiving MDT. A longitudinal retrospective study was conducted at Mohammad Hoesin Hospital, Palembang. Fifty-five leprosy patients were included. Most patients were male, young adults (18–44 years), and classified as multibacillary, with the majority receiving the regular MDT regimen. Notable haematologic changes were identified following MDT administration, with significant changes observed in haemoglobin, mean corpuscular volume, and mean corpuscular haemoglobin. Normocytic normochromic anaemia was the most frequently encountered morphological pattern. Despite these haematologic shifts, no significant association was found between the type of MDT regimen and the incidence of anaemia. Overall, the findings suggest that MDT may contribute to red cell changes reflected in Hb, MCV, and MCH values. Regular haematologic monitoring during therapy is therefore recommended to support early recognition and management of treatment-associated anaemia.