In this issue of Blood, Cuker and Neunert describe their tiered approach to the treatment of refractory immune thrombocytopenia (ITP), and Mahevas et al describe the characteristics and outcomes of patients with ITP refractory to splenectomy, rituximab, and maximal doses of thrombopoietin receptor agonists (TRAs), observing excellent responses to a combination of TRAs with immunosuppression.1,2
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Chaturvedi et al. (2016) studied this question.
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