Volume 3 of Cambridge Medical Reviews: Haematologic Oncology
provides detailed reviews on 10 topics of current interest in
the field of hematologic malignancies. The text is organized into
10 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. The
strength of this chapter resides predominantly in the six tables
used to summarize the epidemiologic data. This tabulation will
provide a useful reference for anyone requiring worldwide epidemiologic
data on these diseases.
The second chapter, authored by David Onions, is a brief introduction
to the role of viruses as etiologic agents of leukemia and lymphoma.
This discussion is well written and easily comprehensible to the
The third chapter on bone marrow stroma microenvironment, by M.I.
Gordon, acts as a basic introduction to this complex, yet relatively
poorly 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 issues
into proper perspective, the emphasis on the MRC trials, which
are listed by their sequential numbers, is somewhat confusing
and detracts from the readability of this text. The chapter would
have been more valuable for the practicing oncologist if it had
presented an overall review of chemotherapy for multiple myeloma,
rather than emphasizing the more general results in comparison
to the MRC trials.
The fifth chapter, by D. Samsom, reviews the field of bone marrow
transplantation for multiple myeloma. It discusses separately
the use of allogeneic, syngeneic, and autologous transplants.
It also explores important issues, including the graft-vs-myeloma
effect and the use of dose-intensification regimens. The chapter
is well organized, and while written from a dose-intensification
perspective, points out that the final answer about the value
of autologous transplantation vs chemotherapy is not yet in.
The sixth chapter, on peripheral blood stem cells for therapeutic
use, is written by C.A. Juttner and L.B. To. This chapter describes
both the theoretical and practical advantages of peripheral stem-cell
transplantation, and illustrates the advantage of peripheral progenitor
transplants 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 myelodysplastic
syndromes, 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 biologic
analysis on this field. This chapter helps the clinician understand
these modern advances, in particular, how these tools allow for
a better understanding of the pathophysiology of these diseases
when compared to morphologic analysis alone.
The eighth chapter, authored by C. Chomienne et al, is a brief
discussion of one of the most exciting treatment results in oncology
over the last decade--the use of retinoids in acute promyelocytic
leukemia. This group's discussion of the clinical activity of
retinoids in this disease is relatively brief, and includes a
hypothesis of how retinoic acid induces complete responses in
patients with acute promyelocytic leukemia.
The ninth chapter, on the cytogenetics of acute lymphoblastic
leukemia, is a useful introduction to this very confusing field.
Table I is a useful summary of the more important chromosomal
abnormalities seen in this disease. Unfortunately, both the table's
overall layout and use of abbreviations make it difficult to read.
The final chapter, on fungal infections complicating hematologic
malignancies, is a useful review of this area for the practicing
oncologist. This chapter is practical in its approach, in that
it avoids the often confusing, detailed listing of all possible
fungal infections seen in such patients. Rather, it focuses on
the most common agents and the best approaches for treating infections
caused by these pathogens.
Overall, the third volume of Haematologic Oncology is filled with
a variety of informative chapters for the practicing physician.
In general, the information is presented in a fashion that should
be useful to the treating oncologist. One drawback is that the
topics chosen are quite diverse, which disrupts the organization
of this text.