Oved JH, et al. - The experts undertook this study to evaluate the initial and long-term outcome of children with persistent/chronic idiopathic thrombocytopenic purpura (ITP) treated with 4 infusions of rituximab and three 4-day cycles of dexamethasone (4R+3Dex) including cohorts with most benefit and/or treatment associated toxicity. In female adolescents with <24 months duration of ITP, durable unmaintained ITP remission after 4R+3Dex was seen almost exclusively. For a subpopulation with hard-to-treat chronic ITP, this provided a new therapeutic paradigm. The pathophysiology of ITP underlying this distinction needed additional clarification.