Thrombotic events, although infrequent, have been reported in ITP patients treated with TPO-RA with an incidence rate ranging from 1.4 to 4.3 per 100 patient-years (1); if we consider the conditions other than ITP, the majority of studies reported an incidence of venous thromboembolism lower than 2% (range 0–1.6%), while higher rates (≥2%) were reported in MDS/AML and postchemotherapy ITP (conditions per se associated with increased thrombotic risk), possibly related to the higher doses of TPO-RA used. The gene discussed is TPO; the disease is myelodysplastic syndrome.