TPO-RAs multitask in ITP.

In this issue of Blood, Liu et al show that response to thrombopoietin receptor agonist (TPO-RA) therapy in immune thrombocytopenia (ITP) is associated with restoration of monocyte Fcg receptor (FcgR) balance toward inhibitory FcgRIIb and with correction of the enhanced phagocytic capacity of macrophages. These data suggest that TPO-RA can increase platelet counts not only by increasing platelet production but also by lowering platelet destruction.