Therapy of adult ITP following splenectomy. (1) The goal of therapy in this population is to maintain a hemostatic platelet count while minimizing drug-induced toxicity; select patients may require somewhat higher platelet counts because of comorbid risk factors as discussed in “Treatment of chronic ITP.” (2) Our preference is to use anti-CD20 if not used previously and we consider reuse if a response was seen prior to splenectomy. Alternatively, we combine danazol with either azathioprine or mycophenolate mofetil for a minimum of 4 months, if possible, and use corticosteroids or IVIG (or both) in the interim, as needed. In the future, thrombopoietic agents currently in clinical trials may be used both before and after splenectomy. prn indicates as needed.