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Original article
Comparison of stem cell sources in the severity of dry eye after allogeneic haematopoietic stem cell transplantation
  1. Miki Uchino1,
  2. Yoko Ogawa1,
  3. Yuichi Uchino1,
  4. Takehiko Mori2,
  5. Shinichiro Okamoto2,
  6. Kazuo Tsubota1
  1. 1Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
  2. 2Keio Bone Marrow Transplant Program, Division of Hematology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
  1. Correspondence to Dr Yoko Ogawa, Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjyuku-ku, Tokyo, Japan; yoko{at}


Aims To compare the incidence and severity of dry eye (DE) after allogeneic haematopoietic stem cell transplantation (HSCT) according to the stem cell source. The authors specifically focused on patients who received bone marrow transplantation (BMT), peripheral blood stem cell transplantation (PBSCT) and cord blood transplantation (CBT).

Methods Ninety-nine HSCT recipients who were prospectively followed-up for at least 100 days at Keio University Hospital were recruited. Ophthalmological examinations included evaluation of ocular surface findings and tear dynamics. The data on systemic graft-versus-host disease were collected by chart review.

Results Of the 99 patients (BMT, 67; PBSCT, 18; CBT, 14), 42 developed DE or showed worsened pre-existing DE after HSCT; 31 (46.3%) BMT group; 8 (44.0%) PBSCT group; and 3 (21.4%) CBT group (p=0.78). The median onset time of DE tended to be later in the PBSCT group (474 days, range 95–1559) than in the BMT (287 days, range 67–1216) or CBT (168 days, range 33–481) group, but the difference was not significant (p=0.23). However, the proportion of patients with severe DE was significantly higher in the PBSCT group (N=7, 87.5%) than in the BMT (N=12, 38.7%) or CBT (N=1, 33.3%) group (p=0.04) and CBT showed the lowest among all three stem cell sources.

Conclusion The data in this study suggested that the severity and onset time of DE were affected by the stem cell source. Close attention must be paid to the development of late-onset severe DE in PBSCT recipients.

  • Dry eye
  • graft-versus-host disease
  • haematopoietic stem cell transplantation
  • stem cell source
  • epidemiology
  • immunology
  • lacrimal gland
  • cornea
  • conjunctiva
  • tears
  • degeneration
  • treatment surgery
  • inflammation
  • medical education
  • wound healing
  • eye (tissue) banking
  • trauma
  • infection
  • optics and refraction
  • anterior chamber

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  • Funding The study was supported by two grants from the Japanese Ministry of Education, Science, Sports and Culture (No. 23592590).

  • Competing interests None.

  • Ethics approval The examination procedure in the outpatient clinic and the examination of documents are within the routine work for patients in the outpatient clinic. The examination procedure for the patients and examination of the patients' documents were approved for dry eye patients by the Institutional Review Board of Keio University. However, no specific approval was obtained for this study.

  • Provenance and peer review Not commissioned; externally peer reviewed.