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. 2022 Nov 16;17(11):e0277655.
doi: 10.1371/journal.pone.0277655. eCollection 2022.

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

Neil K Jairath  1 , Redina Bardhi  2 , John S Runge  1 , Ramona Bledea  1 , Ruple Jairath  1 , Yang Wang  3 , Matthew Patrick  1 , Ryan A Wilcox  4 , Alexandra C Hristov  1   5 , Lam C Tsoi  1   6 , Trilokraj Tejasvi  1   7
Affiliations

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

Neil K Jairath et al. PLoS One. .

Abstract

Background: 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.

Objectives: Here, we seek to characterize the clinicopathologic risk factors that predispose patients with SS to develop LCT.

Methods: 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.

Results: 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.

Conclusions: 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.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Flow diagram detailing inclusion and exclusion of patients at each stage of the collection.
Fig 2
Fig 2. Average time-to-next-treatment (TTNT) analysis measured in days of large cell transformation (LCT) versus non-large cell transformation (NLCT) groups.
The LCT group (blue line) demonstrated significantly decreased mean TTNT compared to the NLCT group (yellow line, HR 5.868, 95% CI 0.0623–0.4661, p = 0.0013).
See this image and copyright information in PMC

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