Weidong Lu, MB, PhD, MPH
Instructor, Department of Medicine, Harvard Medical School
Instructor in Medicine , Osher Research Center, Harvard Medical School-Osher Institute
Professor of Chinese Medicine, Chinese Herbal Medicine, New England School of Acupuncture
Staff acupuncturist, Zakim Center for Integrative Therapies, Dana-Farber Cancer Institute
DF/HCC Program AffiliationGynecologic Cancers
Head and Neck Cancer
To investigate the effect of acupuncture administered during myelosuppressive chemotherapy on white blood cell (WBC) count and absolute neutrophil count (ANC) in ovarian cancer patients.
This study is a pilot, randomized, sham controlled clinical trial. Patients received active acupuncture versus sham acupuncture while undergoing chemotherapy. A standardized acupuncture protocol was employed with manual and electro-stimulation. The frequency of treatment was 2-3 times per week for a total of 10 sessions, starting 1 week before the 2nd cycle of chemotherapy.
Setting: The setting was two outpatient academic centers for patients with cancer.
Subjects: Twenty-one (21) newly diagnosed and recurrent ovarian cancer patients were the subjects.
Outcome measures: WBC count, ANC and plasma granulocyte colony-stimulating factor (G-CSF) were assessed weekly.
The median leukocyte value in the acupuncture arm at the 1st day of the 3rd cycle of chemotherapy was significantly higher than in the control arm after adjusting for baseline value (8,600 cell/μL, range: 4,800-12,000 vs. 4,400 cell/μL, range: 2,300-10,000) (p=0.046). The incidence of grade 2-4 leukopenia was less in the acupuncture arm than in the sham arm (30% vs. 90%; p=0.02). However, the median leukocyte nadir, neutrophil nadir, and recovering ANC were all higher but not statistically significantly different (p=0.116-0.16), after adjusting for baseline differences. There were no statistically significant differences in plasma G-CSF between the two groups.
We observed clinically relevant trends of higher WBC values during one cycle of chemotherapy in ovarian cancer patients, which suggests a potential myeloprotective effect of acupuncture. A larger trial is warranted to more definitively determine the efficacy of acupuncture on clinically important outcomes of chemotherapy-induced neutropenia.