Hematopoietic Cell Transplantation, edited by Drs. Thomas, Blume, and
Forman, is an excellent updated second edition of their comprehensive
textbook designed for both practitioners involved in transplantation
and those interested in the science of stem-cell transplantation. The
new edition, which reflects the contributions of 150 authors, is 50%
larger than the initial textbook due to the inclusion of several new
sections. Also, updated material throughout the book summarizes
scientific progress in the field; references are current up to 1998.
The title has been changed from Bone Marrow Transplantation to
the current one to reflect the fact that bone marrow is no longer the
primary source of hematopoietic cells used for autologous and
The book is divided into eight logically organized sections, each
with a comprehensive review of critical issues. Section I focuses on
the scientific basis for hematopoietic cell transplantation and
includes interesting new chapters on the histocompatibility complex,
new uses for stem-cell transplantation, the molecular aspects of
stem-cell renewal, and chapters on the state of the art
of gene transfer, and early clinical trials of gene therapy using
hematopoietic cells. Also new to this section of the book are
well-written chapters on the molecular techniques used to evaluate
minimal residual disease following hematopoietic transplantation, as
well as chapters on the use of adoptive immunotherapy.
Section I concludes with scholarly, yet comprehensive, chapters on
immunologic issues of transplantation, ranging from induction of
tolerance to the pathophysiology of graft-vs-host responses. Many of
the previously existing chapters have been restructured by new
authors to give them a fresh and updated perspective.
Section IIan entirely new addition for the second
editiondeals specifically with patient-related issues in
transplantation. Although short and to the point, the chapters nicely
cover the critical issues faced by patients undergoing
transplantation, as well as the invaluable roles played by other
members of the transplant team, including nurses, psychologists, and
ethicists. Of particular interest is the chapter on ethical issues in
transplantation, which features carefully discussed clinical
scenarios that must be confronted by patients, their families, and
the clinical team.
Section III is also new, examining the relative explosion
of additional sources of hematopoietic cells used in transplantation
that has occurred since the first edition was published in 1994. This
section includes new chapters on cord blood and in utero
transplantation and the use of peripheral blood stem cells for
allogeneic transplantation, as well as a new, informative chapter on
the structure and function of bone marrow registries.
Section IV deals with the myriad of medical complications that can
and do occur prior to, during, and following transplantation, and the
management of these problems. For the clinician, these chapters
provide an invaluable resource to guide the management of the common,
as well as the rare and difficult, medical issues that arise, ranging
from graft-vs-host disease and infections to specific organ
dysfunction and pain management. Of specific interest to me were
chapters on the hemolytic complications of transplant and a
discussion of the long-term complications following transplantation.
Sections VI and VII comprehensively review the data on allogeneic and
autologous transplantation for specific disease entities. Chapters in
these sections have been expanded, and importantly, updated to
include long-term follow-up data, as well as data from newer trials.
Within the section on allogeneic transplantation, new chapters cover
transplantation for juvenile myelomonocytic leukemia and chronic
lymphocytic leukemia. Another informative chapter explores options
for the management of relapse after allogeneic transplantation, with
a focus on donor lymphocyte infusions.
In this edition, separate chapters have been written on the outcome
of transplantation for acute leukemias in adults vs children, taking
into account the biological differences in the diseases and the
pathophysiology of the distinct groups. The section on autologous
transplantation has also been expanded to include more chapters on
solid tumor transplants and the use of autologous transplantation for
nonmalignant diseases, including human immunodeficiency virus
infection, amyloidosis, and autoimmune disorders. There is also a
well-written chapter on immune strategies designed to prevent relapse
following autologous transplantation. The book concludes with an
interesting, futuristic description of potential issues in the field
of hematopoietic transplantation in the 21st century.
The book is very well edited, with a consistency of format and clear,
graphic depiction of the data. The second edition of Hematopoietic
Cell Transplantation is a worthy successor to the initial
textbook and will be a valuable reference guide for physicians, other
members of the medical team, and scientists interested or involved in
the fascinating and complex field of hematopoietic stem-cell transplantation.