{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,17]],"date-time":"2025-09-17T14:51:32Z","timestamp":1758120692914,"version":"3.37.3"},"reference-count":25,"publisher":"Public Library of Science (PLoS)","issue":"11","license":[{"start":{"date-parts":[[2022,11,16]],"date-time":"2022-11-16T00:00:00Z","timestamp":1668556800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/"}],"funder":[{"DOI":"10.13039\/100000009","name":"Foundation for the National Institutes of Health","doi-asserted-by":"publisher","award":["K01-AR072129"],"award-info":[{"award-number":["K01-AR072129"]}],"id":[{"id":"10.13039\/100000009","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100001582","name":"Dermatology Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100001582","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100003185","name":"National Psoriasis Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100003185","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>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.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Objectives<\/jats:title>\n<jats:p>Here, we seek to characterize the clinicopathologic risk factors that predispose patients with SS to develop LCT.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Methods<\/jats:title>\n<jats:p>We retrospectively evaluated all SS patient records available in the Michigan Medicine Cancer Registry from 2010\u20132021. Clinical and pathologic variables were compared between groups. The Kaplan-Meier method and log-rank test were used to assess overall survival.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Results<\/jats:title>\n<jats:p>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.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec005\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>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.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0277655","type":"journal-article","created":{"date-parts":[[2022,11,16]],"date-time":"2022-11-16T18:35:56Z","timestamp":1668623756000},"page":"e0277655","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["Predictors of large cell transformation in patients with Sezary Syndrome\u2014A retrospective analysis"],"prefix":"10.1371","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2317-169X","authenticated-orcid":true,"given":"Neil K.","family":"Jairath","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Redina","family":"Bardhi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John S.","family":"Runge","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ramona","family":"Bledea","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruple","family":"Jairath","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yang","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew","family":"Patrick","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryan A.","family":"Wilcox","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexandra C.","family":"Hristov","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lam C.","family":"Tsoi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Trilokraj","family":"Tejasvi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2022,11,16]]},"reference":[{"issue":"7","key":"pone.0277655.ref001","doi-asserted-by":"crossref","first-page":"1490","DOI":"10.1016\/j.jid.2016.03.024","article-title":"Identification of Gene Mutations and Fusion Genes in Patients with S\u00e9zary Syndrome","volume":"136","author":"A Prasad","year":"2016","journal-title":"J Invest Dermatol"},{"issue":"10","key":"pone.0277655.ref002","doi-asserted-by":"crossref","first-page":"647","DOI":"10.1111\/j.0303-6987.2005.00495.x","article-title":"WHO\/EORTC classification of cutaneous lymphomas 2005: histological and molecular aspects.","volume":"32","author":"G Burg","year":"2005","journal-title":"J Cutan Pathol"},{"issue":"3","key":"pone.0277655.ref003","doi-asserted-by":"crossref","first-page":"414","DOI":"10.1309\/QH6XLRF3MVUF2M8M","article-title":"Bone marrow histopathologic and molecular staging in epidermotropic T-cell lymphomas","volume":"119","author":"V Sibaud","year":"2003","journal-title":"Am J Clin Pathol"},{"issue":"1","key":"pone.0277655.ref004","first-page":"354","article-title":"EORTC classification for primary cutaneous lymphomas: a proposal from the Cutaneous Lymphoma Study Group of the European Organization for Research and Treatment of Cancer","volume":"90","author":"R Willemze","year":"1997","journal-title":"Blood. 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