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Although patients with immune thrombocytopenic purpura (ITP) often can be treated effectively with corticosteroids, relapses are common. Those who have chronic ITP might receive any of several second-line agents (such as intravenous immunoglobulin, anti-D antibody, danazol, vinca alkaloids, or rituximab), and splenectomy is an option for those whose disease remains refractory to treatment. Many patients experience prolonged remission after this surgery, but some relapse and a small number become unresponsive to further therapy. Although thrombopoietin receptor agonists often boost platelet counts in these patients, relapse usually follows drug discontinuation.
Findings from a recent retrospective study of 19 adults with chronic refractory IT…