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In this retrospective, multicentre, international study, we report the safety and effectiveness of avatrombopag and fostamatininb in combination administered to 18 patients with multirefractory ITP. Overall, the combination response was achieved in 15 patients (83.3%), with a median time from combination start to best response of 15\u2009days (IQR: 8\u201335\u2009days). After a median follow\u2010up of 256\u2009days (IQR: 142.8\u2013319), 5 patients relapsed (26.7%), all during tapering or stopping one drug. Adverse events were described in 6 of 18 patients (33%).<\/jats:p>","DOI":"10.1111\/bjh.19602","type":"journal-article","created":{"date-parts":[[2024,6,19]],"date-time":"2024-06-19T06:59:22Z","timestamp":1718780362000},"page":"1551-1555","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Avatrombopag plus fostamatinib combination as treatment in patients with multirefractory immune thrombocytopenia"],"prefix":"10.1111","volume":"205","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9083-855X","authenticated-orcid":false,"given":"Maria Eva","family":"Mingot\u2010Castellano","sequence":"first","affiliation":[{"name":"Hematology Department Hospital Universitario Virgen del Roc\u00edo, Instituto de Biomedicina de Sevilla (IBIS \/CSIC), Universidad de Sevilla  Sevilla Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose 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