Dr. Srikanth Nagalla, MD, MS, is the chief of benign hematology at Herbert Wertheim Cancer Institute, where he’s working on a new treatment paradigm for immune thrombocytopenia (ITP). In ITP, platelet count remains an essential measure of bleeding risk, but it does not always reflect how patients feel or function. The goal is not broad immunosuppression; it is to rebalance immune signaling in a manner that engages multiple relevant pathways while preserving normal immune function. Nagalla: The primary safety consideration is achieving meaningful immune modulation without compromising normal immune function. Nagalla: Endpoints such as fatigue or cognitive function should be incorporated prospectively using validated patient-reported outcome instruments and functional assessments alongside traditional clinical measures.