Limbal Stem Cell Deficiency Arising From Systemic Chemotherapy With Hydroxycarbamide

Purpose: The purpose of this study was to report a case of limbal stem cell deficiency (LSCD) after systemic chemotherapy with hydroxycarbamide. Methods: Clinical manifestations and pathology are detailed. Results: We describe the case of a woman with sickle cell disease, who developed bilateral LSCD after treatment with hydroxycarbamide. Histologic examination confirmed the diagnosis of LSCD, revealing goblet cells, inflammatory cells, deposits of new collagen components. and neovascularization in the peripheral cornea. Matrix metalloproteinase-3, fibronectin. and collagen III were also detected in the lesions. Conclusions: The systemic use of the antineoplastic drug, hydroxycarbamide, may cause severe LSCD. We recommend that a medication history, including that of cytotoxic drugs, be considered in evaluating LSCD.