Markers of refractory primary immune thrombocytopenia

Summary Refractory immune thrombocytopenia (ITP) is a challenging disease that can be defined by refractoriness to second‐line treatments. In this review, we list and comment available evidence about clinical and biological factors associated with refractoriness to splenectomy, thrombopoietin receptor agonists (TPO‐RAs), rituximab and fostamatinib, as well as those associated with multirefractory ITP (active disease with failure of rituximab, TPO‐RAs and splenectomy).