Unfavorable prognostic significance of hand mirror cells in childhood acute lymphoblastic leukemia. A report from the childrens Cancer Study Group.

Overview

The prognostic significance of hand mirror cells (HMCs) in childhood acute lymphoblastic leukemia was determined by quantifying the percentage of these cells in the diagnostic bone marrow aspirates of previously untreated children entered on the Childrens Cancer Study Group protocol 141. Of 664 examinable patients, 39 (5.9%) had greater than 10% HMCs, and only four (0.6%) had greater than 30% HMCs. Compared with the entire study population, a greater proportion of children with more than 10% HMCs were older than 10 years of age, had hemoglobin levels greater than 10 g/dL, and had undifferentiated lymphoblast morphology. The children with more than 10% HMCs had a higher rate of bone marrow relapse, poorer disease-free survival, and shorter survival than patients with less than 10% HMCs. By multivariate analysis, HMC morphology was an independent, unfavorable prognostic factor.