Patients who have newly diagnosed
leukemia are often overwhelmed with the complexities of their disease
and its required therapy. In their book, Understanding Leukaemia
and Related Cancers, Drs. Mughal and Goldman offer patients a
valuable guide to the diagnosis and treatment of leukemia. The
authors note that the book is intended for a varied audience, but I
believe that it will be most useful to patients and family members
who seek a better understanding of the disease and its implications.
The book consists of eight chapters, the first three of which attempt
to provide readers with the scientific background that will help them
gain a better understanding of the disease process. The authors have
done an excellent job of explaining complicated medical information
in relatively easy-to-understand language, and the well-chosen
illustrations will likely add to the readers comprehension.
The prevalence of leukemia, as well as the possible etiologies for
its development, are discussed. Many patients fear that they may have
done something to cause their cancer, and the authors go to some
length to try to dispel these concerns. They also provide a valuable
resource in Appendix 1a list of many active support
organizations in the United Kingdom, the United States, and Spain.
The remaining chapters describe the diagnosis and treatment of the
various types of leukemia. Clear, simple language is used to explain
the usual work-up that is performed on the leukemia patient, as well
as the rationale behind various procedures.
The potential benefits and toxicities of chemotherapy and radiation
are discussed, and a separate chapter on bone marrow transplantation
is also included. The authors remember to include toxicities that
occur with certain therapies, such as red urine with daunorubicin
(Cerubidine), that are not dangerous but that, nonetheless, may be
frightening to the unprepared patient.
The authors also address the importance of patient participation in
clinical trials. They make the important point that 90% of children
in the United Kingdom with acute lymphoblastic leukemiaa
disease in which tremendous advances have been madeare entered
into clinical trials.
Although the chapter on leukemia therapy is well written, it contains
a few inaccuracies. For example, the section on the treatment of
hairy-cell leukemia is outdated: Treatment with interferon is
emphasized, and 2-chlorodeoxyadenosine (cladribine [Leustatin]) is
mentioned only briefly. Also, the authors state that high-dose
cytarabine is used only occasionally when, in fact, it has now become
the standard consolidation therapy for many patients with acute
The books final chapter ends on a hopeful note by discussing
future therapeutic prospects. Targeted therapy, such as gene therapy,
is described, as well as some of the controversies surrounding bone
Any book that informs patients is always a valuable resource. Despite
its few shortcomings, Understanding Leukaemia and Related Cancers
provides patients and their families with much of the information
that they will need for proper decision-making throughout the course
of their disease. It also manages to present this complicated
information in a simple, nonthreatening manner. Patients will likely
find this book to be most useful as a starting point for further
discussion with their physicians.