MF with large-cell transformation (LCT — ≥25% large cells on biopsy review) — aggressive...

Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.

ID	`RF-MF-LARGE-CELL-TRANSFORMATION`
Type	Red flag
Status	reviewed 2026-04-25 \| pending_clinical_signoff
Diseases	`DIS-MF-SEZARY`
Sources	`SRC-ESMO-CTCL-2024` `SRC-NCCN-BCELL-2025`

Red Flag Origin

Definition	MF with large-cell transformation (LCT — ≥25% large cells on biopsy review) — aggressive variant; mandates systemic therapy reassessment, brentuximab vedotin if CD30+
Clinical direction	intensify
Category	transformation-progression
Shifts algorithm	ALGO-MF-SEZARY-1L

Trigger Logic

{
  "any_of": [
    {
      "finding": "BIO-MF-LCT",
      "value": "positive"
    },
    {
      "finding": "large_cell_transformation",
      "value": true
    }
  ],
  "type": "biomarker"
}

Notes

LCT prognosis dismal (median OS 2-4y from LCT). CD30+ subset (~30-50%) → ALCANZA-style brentuximab vedotin monotherapy preferred over chemotherapy. Distinct entity from primary cutaneous ALCL. Skin-directed alone never appropriate post-LCT.

MF with large-cell transformation (LCT — ≥25% large cells on biopsy review) — aggressive...

Red Flag Origin

Trigger Logic

Notes

Used By

Algorithms

Indications