My husband has been diagnosed at the age of 37, we have done a bone marrow biopsy, immune suppression infusions (those landed him in the hospital for a week due to a very rare but severe reaction), and now is on Promacta. I am curious if your husband had an ultrasound of his spleen done that showed that it was enlarged? The reason I ask is because mine did and they said it was not enlarged but since he had a bad reaction to the infusions, they said splenectomy was the next step. We discussed that we were 100% comfortable with this option and that is when we got put on Promacta. Problem is the Promacta is not working at the current dosage. They are going to up the dosage to the next level.