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Despite a plethora of therapies, some patients with chronic immune thrombocytopenia (IT) have persistently low platelet counts and fail to respond to splenectomy, rituximab, and thrombopoietin-receptor agonists. But the characteristics of such patients and an optimal management strategy for them are unknown.
To address this dearth of information, investigators from France conducted a multicenter retrospective cohort study of 37 patients with multirefractory IT and a matched control group of 183 patients with conventional IT.
Refractory patients were more likely than controls to have the following:
Secondary IT (odds ratio, 4.84; P=0.018)
Monoclonal gammopathy of undetermined significance (OR, 5.94; P<0.04)
Bleeding symptoms at onset (OR, 3.54; P…