In case of refractory thrombocytopenia despite IVIG, corticosteroids, TPO-RAs, and rituximab, the use of fostamatinib, which is a tyrosine kinase inhibitor recently approved in 2018 by the FDA for the treatment of chronic ITP unresponsive to previous therapies, might be considered (84). This evidence concerns the gene TPO and Thrombocytopenia.