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Limbal stem cell deficiency arising from systemic chemotherapy with hydroxycarbamide
Xiaoyan Ding1, Rachel J Bishop, Alexandra A Herzlich
1Section of Immunopathology, Laboratory of Immunology, National Eye Institute, National Institutes of Health, Bethesda, MD 20892-1857, USA.
Cornea
|January 23, 2009
Summary
Systemic hydroxycarbamide, a chemotherapy drug, can cause severe limbal stem cell deficiency (LSCD). This case highlights the importance of considering cytotoxic drug history in diagnosing LSCD.
Area of Science:
- Ophthalmology
- Hematology
- Pharmacology
Background:
- Limbal stem cell deficiency (LSCD) is a sight-threatening condition.
- Hydroxycarbamide is used to treat sickle cell disease and other myeloproliferative disorders.
Observation:
- A woman with sickle cell disease developed bilateral LSCD after hydroxycarbamide treatment.
- Clinical and histological findings confirmed LSCD, including goblet cell presence, inflammation, and corneal neovascularization.
Findings:
- Histopathology revealed new collagen components, matrix metalloproteinase-3, fibronectin, and collagen III in corneal lesions.
- These findings suggest a direct toxic effect of hydroxycarbamide on limbal stem cells.
Implications:
- Systemic hydroxycarbamide can induce severe LSCD.
- Ophthalmologists should inquire about cytotoxic drug use in patients presenting with LSCD.
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