Predictors of large cell transformation in patients with Sezary Syndrome-A retrospective analysis

Large cell transformation (LCT) of Sezary Syndrome (SS) is a rare phenomenon. To date, there are no rigorous studies identifying risk factors for its development. Here, we seek to characterize the clinicopathologic risk factors that predispose patients with SS to develop LCT. We retrospectively eval...

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Bibliographic Details
Published in:PloS one 2022-11, Vol.17 (11), p.e0277655
Main Authors: Jairath, Neil K, Bardhi, Redina, Runge, John S, Bledea, Ramona, Jairath, Ruple, Wang, Yang, Patrick, Matthew, Wilcox, Ryan A, Hristov, Alexandra C, Tsoi, Lam C, Tejasvi, Trilokraj
Format: Article
Language:English
Subjects:
Biology and life sciences
Biopsy
Blood
Blood tests
Cancer
CD8 antigen
Cell Transformation, Neoplastic
Electronic health records
Flow cytometry
Genetic transformation
Histopathology
Humans
L-Lactate Dehydrogenase
Lactate dehydrogenase
Lactic acid
Lymphoma
Medical diagnosis
Medical prognosis
Medicine and health sciences
Melanoma
Metastasis
Mycosis Fungoides - pathology
Patients
Peripheral blood
Prognosis
Rank tests
Retrospective Studies
Risk analysis
Risk factors
Sezary syndrome
Sezary Syndrome - pathology
Skin Neoplasms - pathology
Tomography
Transformation
Variables
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Summary:Large cell transformation (LCT) of Sezary Syndrome (SS) is a rare phenomenon. To date, there are no rigorous studies identifying risk factors for its development. Here, we seek to characterize the clinicopathologic risk factors that predispose patients with SS to develop LCT. We retrospectively evaluated all SS patient records available in the Michigan Medicine Cancer Registry from 2010-2021. Clinical and pathologic variables were compared between groups. The Kaplan-Meier method and log-rank test were used to assess overall survival. Of 28 SS patients identified, eight patients experienced LCT, and 20 did not (NLCT). Peak lactate dehydrogenase (LDH) before LCT (p = 0.0012), maximum total body surface area (TBSA) involvement before LCT (p = 0.0114), absolute CD8+ cell count measured on flow cytometry at diagnosis of SS (p = 0.0455) and at the most recent blood draw (p = 0.00736), and ulceration on biopsy (p = 0.0034) were significant clinicopathologic variables identified between the SS patients that developed LCT versus those that did not. Maximum TBSA involvement, peak LDH, presence of ulceration, and decreased levels of CD8+ cells in the peripheral blood may predict the development of LCT in patients with SS.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0277655