Clinical effectiveness of acupuncture in the treatment of chemotherapy-induced leukopenia: A systematic review

IntroductionClinical studies have suggested that acupuncture may be useful in the treatment of chemotherapy-induced leukopenia, a commonly encountered adverse event experienced by cancer patients. The aim of this meta-analysis was to determine the clinical effectiveness of acupuncture for this indication.MethodsA search for randomized controlled trials was carried out using the following databases; China National Knowledge Infrastructure (CNKI), Excerpta Medica dataBASE (EMBASE), Public/Publisher MEDLINE (PubMed), and Cochrane Central Register of Controlled Trials (CENTRAL). The included trials were assorted into several subgroups according to the acupuncture type, and the rate of leukopenia was meta-analyzed in each subgroup. The methodological quality of these studies was assessed using the criteria for systematic reviews recommended by the Cochrane Collaboration.ResultsFour types of acupuncture were used in the included studies; conventional manual acupuncture (CA: 3 trials, n = 178), pharmacopuncture (PA: 3 trials, n = 187), warm needle acupuncture (WA: 1 trial, n = 57), and fire needle acupuncture (FA: 1 trial, n = 60). CA (RR, 0.62, 95% CI, 0.43-0.91; P = 0.01) and FA (RR, 0.20, 95% CI, 0.05-0.84; P = 0.03) reduced the leukopenia rate with statistical significance. The methodological quality was found to be insufficient, since all the included studies were at unclear or high risk of bias for at least two of six domains.ConclusionsThe results suggest that CA and FA might be beneficial for chemotherapy-induced leukopenia. However, more well-planned studies are still needed due to the small number of studies available for analysis and the considerable methodological flaws in the analyzed trials.