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The spleen is pivotal in the pathogenesis of ITP, yet little is known on its immune microenvironment and on effects of TPO\u2010RA on this organ. To address these topics, we analysed 35 spleens removed for primary refractory ITP. Pre\u2010splenectomy TPO\u2010RA administration correlated with increased splenic regulatory T cells (Tregs), type 2 T\u2010helper cells and histiocyte density and with reduced red pulp sinusoids. Surgical outcome was not associated with TPO\u2010RA administration, other pre\u2010splenectomy therapies and\/or Treg density. In conclusion, TPO\u2010RA affect the splenic microenvironment, but this has no impact on splenectomy outcome.<\/jats:p>","DOI":"10.1111\/bjh.18309","type":"journal-article","created":{"date-parts":[[2022,6,15]],"date-time":"2022-06-15T04:29:25Z","timestamp":1655267365000},"page":"916-922","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Thrombopoietin receptor agonists increase splenic regulatory T\u2010cell numbers in immune thrombocytopenia"],"prefix":"10.1111","volume":"198","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4006-7317","authenticated-orcid":false,"given":"Marco","family":"Pizzi","sequence":"first","affiliation":[{"name":"Surgical Pathology and Cytopathology Unit, Department of Medicine\u2010DIMED University of Padua School of Medicine  Padua 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