Supplementary Material for: Warm acupuncture for Refractory Thrombocytopenia Induced by Cancer Treatment:Two Case Reports

Introduction：Cancer treatment-induced thrombocytopenia (CTIT) is a common adverse complication during antineoplastic treatment. Although standardized Western medical treatment is available, CTIT cannot be totally improved in some patients due to the severe degree of myelosuppression or low sensitivity to thrombopoietic agents. Case Presentation：We report two cases of cancer treatment-induced thrombocytopenia (CTIT) that demonstrated insufficient response to conventional platelet-raising treatment, but achieved better curative effect after the addition of warm acupuncture therapy. Case 1: A 50-year-old man was diagnosed with right-sided renal carcinoma accompanied by multiple metastases of both lungs and multiple bone metastases. After radiotherapy and immunotherapy, the patient developed thrombocytopenia. On February 28, the blood routine examination indicated that the platelet count was 24×109/L, which dropped to 20×109/L three days later. Conventional platelet-raising therapy has shown suboptimal efficacy, and the patient was unable to have a platelet transfusion due to irregular antibodies on his blood-crossing test, so warm acupuncture therapy was initiated as a complementary treatment on March 21. After two weeks of acupuncture treatment, the patient's platelet count steadily increased (68×109/L, April 3) and eventually returned to normal (122×109/L, April 18). Case 2: A 61-year-old woman was diagnosed with primary ovarian adenocarcinoma and developed thrombocytopenia after receiving chemotherapy and radiotherapy, which was suspended due to a persistent decrease in platelet count. After more than 14 days of platelet-raising medication, the patient’s platelet count continued to drop (39×109/L, April 17). After combined one course of warm acupuncture treatment, her platelet count rebounded (48×109/L, April 21), so radiotherapy was continued, and the patient's platelet count returned to normal after two courses of combined warm acupuncture treatment (187×109/L, April 26). Conclusion：Warm acupuncture may be a potentially complementary treatment for refractory CTIT.