Clinical Challenging Cases series: Novel Options for Refractory Cancer Therapy-induced Thrombocytopenia（r-CTIT）

Abstract Purpose Refractory cancer therapy-induced thrombocytopenia (r-CTIT) presents a life-threatening complication of tumor therapy, for which there is currently no established and effective long-term treatment. Methods Umbilical cord blood (UCB) is rich in hematopoietic stem cells with multi-lineage differentiation potential, while umbilical cord mesenchymal stem cells (UC-MSCs) have been shown to support megakaryocytopoiesis and regulate the bone marrow microenvironment. The components of cells have demonstrated great value in the treatment of hematopoietic failure diseases, especially in patients with r-CTIT.To investigate the impact of intravenous sequential infusion of UCB and UC-MSCs in patients with r-CTIT, we conducted a follow-up study. Results Among the 13 patients evaluated, the platelet response rate was 84.6% (11/13). Complete response (CR) was observed in 53.8% (7/13) of the patients, while partial response (PR) was seen in 84.6% (9/13) of the patients. The median time for platelet recovery in all patients was 53 days (range: 6-217 days). Our findings revealed that the infusion of UCB and UC-MSCs in r-CTIT patients has shown positive effects on erythroid and neutrophil levels, with an 84.6% erythroid response rate (11/13) and a 92.3% improvement in neutrophil count. Furthermore, no severe adverse reactions to the infusion were observed. Conclusions Based on our study, we can conclude that the sequential infusion of UCB and UC-MSCs can be a novel and promising therapeutic approach for r-CTIT patients.