{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T13:23:04Z","timestamp":1790256184713,"version":"4.1.0"},"reference-count":26,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T00:00:00Z","timestamp":1774224000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T00:00:00Z","timestamp":1774224000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Cutan Pathol"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Large cell transformation (LCT) in mycosis fungoides (MF) is thought to represent the clonal evolution of a single clone and is associated with aggressive clinical behavior and poor outcome not overcome by aggressive treatment regimens. The tumor dynamics leading to LCT\u2010MF are poorly understood and previously determined genetic alterations in MF do not explain nor can predict disease progression and\/or transformation, although implicating driver mutations have been identified. Our aim is to describe a distinct case of MF and the evolution of a genomic signature after LCT. This brief report highlights the evolution of genetic mutations seen in a 30\u2010year\u2010old Caucasian female with MF, folliculotropic type, who failed multiple treatment regimens and ultimately progressed with histologically confirmed LCT. The genomic analysis of five separate tumor samples, which originally harbored\n                    <jats:italic>NRAS<\/jats:italic>\n                    and\n                    <jats:italic>PLCG1<\/jats:italic>\n                    , showed molecular evolution with new somatic mutations in\n                    <jats:italic>ATM<\/jats:italic>\n                    ,\n                    <jats:italic>CARD11<\/jats:italic>\n                    ,\n                    <jats:italic>TET2<\/jats:italic>\n                    ,\n                    <jats:italic>TP53<\/jats:italic>\n                    ,\n                    <jats:italic>U2AF1<\/jats:italic>\n                    , and copy number variation including amplification of\n                    <jats:italic>CDK6 and EIF4E<\/jats:italic>\n                    , loss of\n                    <jats:italic>CDKN2A<\/jats:italic>\n                    ,\n                    <jats:italic>CDKN2B<\/jats:italic>\n                    , and\n                    <jats:italic>IKZF1<\/jats:italic>\n                    oncogenic isoform and high tumor burden, which were not seen in samples prior to LCT. The new somatic alterations seen with the clinical progression of LCT suggest evolution of the molecular tumor environment. Many of the mutations described implicate driver mutations in advanced\u2010stage MF and have been associated with poor survival. While there is no evidence suggesting a singular mutation for the pathogenesis of LCT, the constellation of mutations may be responsible for histologic progression to LCT.\n                  <\/jats:p>","DOI":"10.1111\/cup.70095","type":"journal-article","created":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T06:47:23Z","timestamp":1774334843000},"page":"596-604","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Molecular Genetic Demonstration of the Evolution of Transformed Mycosis Fungoides: A Clinicopathological and Molecular Case Study"],"prefix":"10.1111","volume":"53","author":[{"given":"Melissa","family":"Cheng","sequence":"first","affiliation":[{"name":"Division of Dermatology City of Hope Medical Center  Duarte California USA"},{"name":"College of Osteopathic Medicine of the Pacific Western University of Health Sciences  Pomona California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liliana","family":"Crisan","sequence":"additional","affiliation":[{"name":"Division of Dermatology City of Hope Medical Center  Duarte California USA"},{"name":"Beckman Research Institute  Duarte California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jasmine","family":"Zain","sequence":"additional","affiliation":[{"name":"Department of Hematology &amp; Hematopoietic Cell Transplantation City of Hope Medical Center  Duarte California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5830-6158","authenticated-orcid":false,"given":"Michelle","family":"Afkhami","sequence":"additional","affiliation":[{"name":"Department of Pathology City of Hope Medical Center  Duarte California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christiane","family":"Querfeld","sequence":"additional","affiliation":[{"name":"Division of Dermatology City of Hope Medical Center  Duarte California USA"},{"name":"Beckman Research Institute  Duarte California USA"},{"name":"Department of Hematology &amp; Hematopoietic Cell Transplantation City of Hope Medical Center  Duarte California USA"},{"name":"Department of Pathology City of Hope Medical Center  Duarte California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,23]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2018-11-881268"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2011-08-376319"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2020001441"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/exd.13261"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/ng.3356"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.leu.2403202"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1038\/ng.3444"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2017-02-768234"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1038\/ng.3442"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1038\/modpathol.2009.196"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.2340\/actadv.v101.570"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.celrep.2023.113110"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcmm.18475"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41417-024-00730-6"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/tra.12546"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cell.2012.06.024"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2021013568"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mrfmmm.2010.10.005"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.semcancer.2019.08.008"},{"key":"e_1_2_13_21_1","doi-asserted-by":"publisher","DOI":"10.1126\/sciadv.add4920"},{"key":"e_1_2_13_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/ddg.13514"},{"key":"e_1_2_13_23_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamadermatol.2016.1597"},{"key":"e_1_2_13_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/PAT.0000000000000166"},{"key":"e_1_2_13_25_1","doi-asserted-by":"publisher","DOI":"10.1136\/jclinpath-2018-205324"},{"key":"e_1_2_13_26_1","article-title":"T Cell Receptor Clonotypes Associated With Aggressive Subtypes in Cutaneous T Cell Lymphoma","volume":"43","author":"Crisan L. 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