Book Review: Cambridge Medical Reviews--Haematologic Oncology, Volume 3

Volume 3 of Cambridge Medical Reviews: Haematologic Oncologyprovides detailed reviews on 10 topics of current interest inthe field of hematologic malignancies. The text is organized into10 chapters and has 22 contributors.

The initial chapter, on the epidemiology of non-Hodgkin's lymphoma,is a compendium of epidemiologic data from multiple sources. Thestrength of this chapter resides predominantly in the six tablesused to summarize the epidemiologic data. This tabulation willprovide a useful reference for anyone requiring worldwide epidemiologicdata on these diseases.

The second chapter, authored by David Onions, is a brief introductionto the role of viruses as etiologic agents of leukemia and lymphoma.This discussion is well written and easily comprehensible to thepracticing oncologist.

The third chapter on bone marrow stroma microenvironment, by M.I.Gordon, acts as a basic introduction to this complex, yet relativelypoorly understood, area of hematopoiesis.

The fourth chapter is an analysis of treatment for multiple myeloma,with an emphasis on the Medical Research Council (MRC) trials.While the discussion of the literature as a whole puts many issuesinto proper perspective, the emphasis on the MRC trials, whichare listed by their sequential numbers, is somewhat confusingand detracts from the readability of this text. The chapter wouldhave been more valuable for the practicing oncologist if it hadpresented an overall review of chemotherapy for multiple myeloma,rather than emphasizing the more general results in comparisonto the MRC trials.

The fifth chapter, by D. Samsom, reviews the field of bone marrowtransplantation for multiple myeloma. It discusses separatelythe use of allogeneic, syngeneic, and autologous transplants.It also explores important issues, including the graft-vs-myelomaeffect and the use of dose-intensification regimens. The chapteris well organized, and while written from a dose-intensificationperspective, points out that the final answer about the valueof autologous transplantation vs chemotherapy is not yet in.

The sixth chapter, on peripheral blood stem cells for therapeuticuse, is written by C.A. Juttner and L.B. To. This chapter describesboth the theoretical and practical advantages of peripheral stem-celltransplantation, and illustrates the advantage of peripheral progenitortransplants over marrow-based transplants.

The seventh chapter, written by D.J. Culligan and A.K. Burnett,is entitled "The Laboratory Aspects of Myelodysplasia."This chapter starts with the morphologic definitions of the myelodysplasticsyndromes, as determined by the French-American-British (FAB)Group in 1982. It then discusses the impact of cytogenetics, immunohistochemistry,immunophenotyping, progenitor growth studies, and molecular biologicanalysis on this field. This chapter helps the clinician understandthese modern advances, in particular, how these tools allow fora better understanding of the pathophysiology of these diseaseswhen compared to morphologic analysis alone.

The eighth chapter, authored by C. Chomienne et al, is a briefdiscussion of one of the most exciting treatment results in oncologyover the last decade--the use of retinoids in acute promyelocyticleukemia. This group's discussion of the clinical activity ofretinoids in this disease is relatively brief, and includes ahypothesis of how retinoic acid induces complete responses inpatients with acute promyelocytic leukemia.

The ninth chapter, on the cytogenetics of acute lymphoblasticleukemia, is a useful introduction to this very confusing field.Table I is a useful summary of the more important chromosomalabnormalities seen in this disease. Unfortunately, both the table'soverall layout and use of abbreviations make it difficult to read.

The final chapter, on fungal infections complicating hematologicmalignancies, is a useful review of this area for the practicingoncologist. This chapter is practical in its approach, in thatit avoids the often confusing, detailed listing of all possiblefungal infections seen in such patients. Rather, it focuses onthe most common agents and the best approaches for treating infectionscaused by these pathogens.

Overall, the third volume of Haematologic Oncology is filled witha variety of informative chapters for the practicing physician.In general, the information is presented in a fashion that shouldbe useful to the treating oncologist. One drawback is that thetopics chosen are quite diverse, which disrupts the organizationof this text.