Escalation of therapy with rituximab and thrombopoietin receptor agonists (TPO-RA) (eltrombopag or romiplostim) was needed in 22 patients (four patients had pre-existing ITP while 18 were newly diagnosed), out of which, in addition, two received vinca alkaloids, two received aminocaproic acid, one received danazol, one received Rho IgG, and one received fostamatinib. This evidence concerns the gene MPL and autoimmune thrombocytopenic purpura.