Eligibility Criteria:
Inclusion Criteria:
* Age 18-60 years old;
* Diagnosis of primary immune thrombocytopenia according to the guidelines of American Society of Hematology for at least 3 months before inclusion;
* Platelet count \<30×109/L (measured at least twice during the screening, with at least a 1-week interval);
* Failed or dependent on or relapsed after previous treatment with glucocorticoid;
* If on glucocorticoid maintenance therapy, dose ≤0.5 mg/kg prednisone or equivalent and stabilised for at least 4 weeks;
* Drugs such as azathioprine, danazol, cyclosporine A, tacrolimus, and sirolimus stopped for at least 4 weeks;
* Splenectomy more than 6 months previously;
* Previous rescue therapy of ITP (including methylprednisolone, platelet transfusion and IVIG) completed at least 2 weeks before the first administration;
* Liver and kidney function (including alanine aminotransferase, aspartate aminotransferase, total bilirubin, serum creatine, urea nitrogen, etc.) less than 1.5 times the upper limit of normal value;
* Eastern Cooperative Oncology Group performance status ≤2;
* Cardiac function classification (New York Heart Association) ≤2;
* Understand the research procedure and voluntarily sign a written informed consent form.
Exclusion Criteria:
* Patients with secondary thrombocytopenia (including myelodysplastic syndrome, aplastic anemia, common variant immunodeficiency disease, hereditary thrombocytopenia, drug-induced thrombocytopenia, pseudothrombocytopenia, connective tissue disease secondary thrombocytopenia, thrombocytopenia after liver disease, etc.);
* Previous treatment of RTX or allergic to RTX;
* Uncontrollable primary diseases of important organs (including malignant tumor, liver failure, heart failure, kidney failure and other diseases);
* HIV-positive status;
* Active infection including hepatitis B (HBV), hepatitis C (HCV) and other viral antigens or DNA, RNA positive; cytomegalovirus, Epstein-Barr virus, syphilis chronic or active infection. If HBV core antibodies are positive, HBV-DNA testing is required.
* Extensive and severe bleeding, such as hemoptysis, upper gastrointestinal hemorrhage, intracranial hemorrhage, etc.
* Heart disease or arrhythmia need treatment, or poorly controlled hypertension;
* Thrombotic diseases including pulmonary embolism, thrombosis, atherosclerosis, etc.;
* Previously allogeneic stem cell transplantation or organ transplantation;
* Mental disorders who are unable to obtain informed consent normally and participate in trials and follow-up;
* Symptoms of toxicity from pre-trial treatment have not resolved;
* Other severe conditions that may limit participation in the trial (e.g., diabetes; severe cardiac insufficiency; myocardial infarction or unstable arrhythmia or unstable angina within the last 6 months; gastric ulcer; active autoimmune diseases, etc.);
* Sepsis or other irregular bleeding;
* Taking antiplatelet drugs;
* pregnancy, suspected pregnancy (urine human chorionic gonadotropin positive during screening) or lactation.