SECOND LINE OPTIONSMMF max1200 mg/m2 dayWean off after 6-12 months > 3-6 months (if successful, keep dosage as low as possible)If DNT ↑: Sirolimus 2 to 2.5 mg/m2/dayTPOR-Agonists:Eltrombopag 25-50 (75) mg/day (0.8-1.2 mg/kg <6y) orallyRomiplostin (>18yrs or eltr. non responders) 100-250 ug/m (2 )weekIf signs of CID: consider targeted therapy, HSCTRituximab (discussed as 2nd or 3rd line therapy) 375 mg/m2 once per week, 4 times especially in case of: chronic EBV infection, high CD19+ frequency. This evidence concerns the gene CD19 and Epstein-Barr virus infection.