Hematology of Infancy and Childhood (6th Edition)


DG Nathan, SH Orkin et al
Published by Saunders (2003)
Distributed in Australia by Elsevier
ISBN:  0-7216-9317-2.  1,864 pages plus index.
RRP:  A$708.40

This is the sixth edition of Hematology of infancy and childhood – to most, the key text in paediatric haematology.  The previous editions have been heavy in weight, but very complete in context, and have presented conditions/diseases based around current biological information and pathophysiology.  This approach has been maintained in the sixth edition.

The textbook is divided into two volumes, making handling easier. The first volume focuses on neonatal haematology, bone marrow failure syndromes, disorders of red cell production, haemolytic anaemia, disorders of haemoglobin and the phagocyte system.  The first chapter on the historical perspective of paediatric haematology is an excellent means of introducing the text.

For the purpose of this review, I have been asked to focus on the oncology component of the text, which has changed markedly from the previous editions.  Previous editions have included specific chapters on the epidemiology, molecular biology and chromosomal abnormalities in childhood cancer.  Additionally principles of paediatric radiation therapy and management of malignant solid tumours were included. The editors of the sixth edition, in particular Thomas Look, have “totally reconstructed” the section on oncology.  As this is essentially a textbook on haematological conditions, the chapters specific to solid tumours, radiation therapy have been omitted. The section on oncology, now appropriately, is devoted to haematological malignances. The authors comprehensively cover epidemiology including prenatal origins of ALL and current controversies, chromosomal abnormalities with discussion on newer methods for identification; and the leukaemias and approaches to treatment, incorporating a chapter on the pharmacology of antineoplastic agents and multidrug resistance. Lymphoma, lymphadenopathy and lymphohistiocytic disorders also are covered. Importantly the molecular basis of haematological malignancy is covered in a chapter which clearly describes, with the use of excellent figures, the complicated intracellular signaling and transduction pathways.  This chapter also describes current technological approaches, which is very useful for the clinician. Assessment of MRD also is described clearly by the author. Also of relevance to the oncologist is the complete chapter on acquired disorders of haemostasis.

In summary, this text is the key reference for paediatric haematologists. The information is clearly and very comprehensively presented and is current. The figures, diagrams, illustrations and photomicrographs are excellent. The loss of chapters on solid tumours and management mean that those training in paediatric haematology will need to source other texts for reference, but the information on haematological malignancy is very complete. This text remains an essential for the library of the paediatric haematologist/oncologist.

H Irving
Dept Haematology & Oncology
Royal Children’s Hospital
Herston, QLD

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