In addition, the probability of using cortisol drugs for the first recurrence is approximately 75%, while the probability of using TPO-RA and rituximab for the second and third recurrences is increased to 57 and 52%, respectively.27When second-line drug treatment fails, the immune disorder mechanism in the patient's body becomes more complex, leading to an increased incidence of refractory ITP. This evidence concerns the gene TPO and immune system disorder.