Book Reviews

Wintrobes Clinical Haematology, 10th edn. Edited by G. R. LEE,

J. FOERSTER, J. LUKONS, F. PARASKEVAR, J. P. GREER and
G. M. RODGERS. Williams and Wilkins, Baltimore, 1999.
Pp. 2764. 120.
1999 sees the new tenth edition of Wintrobes Clinical
Haematology. The book now stretches to 2764 pages
contained in two volumes. The introductory sections open
with diagnostic approaches, including immunological,
cytogenetic and molecular techniques. Normal blood cells,
haemostasis and transfusion/transplantation then follow.
Clinical subjects are divided into disorders of red cells,
haemostasis and white cell disorders, both non-malignant
and malignant. The book is written exclusively by North
American authors, with a Southern bias. Thus practice has
an American avour, e.g. the ASH guidelines for manage-
ment of ITP are followed closely, which are considerably
more aggressive than British and, I suspect, most European
management.
When considering whether to buy or read this book, it
comes down to two issues. Firstly, is a textbook of this size
worth buying? Increasingly, to look up a single topic ones
thoughts turn rst towards electronic retrieval databases
such as Medline. Haematology is becoming ever more
specialized, and books covering individual subspecialties
are becoming increasingly common. The detail contained
within, e.g. the transfusion or transplantation sections,
would not allow safe specialist practice within those areas
but instead provide overviews. Nevertheless, many of us
remain generalists to some degree, and trainees often benet
from books at this level. The usual criticism of some chapters
being out of date can be made; for instance, the haemo-
chromatosis gene remains uncloned.
Having decided that a large textbook is required, which
one should be consulted? This is an even more difcult
decision. My own opinion is that, like so many other
consumer products, it is increasingly difcult to differentiate
between the large textbooks. Notable relative weaknesses
have been identied and eliminated. I would say that
Wintrobe is better on clinical problems and correspondingly
weaker on the underlying scientic basis than its main
competitors. For instance, the molecular basis for HD merits
two paragraphs, compared to 15 pages on treatment. The
molecular genetics of haemophilia is dismissed in a sentence,
with the ip tip inversion unmentioned. Although I could
quibble with individual points, I was impressed by the
balanced approach to most of the clinical problems that I
tried it with. A possible exception is weak coverage on the
diagnostic approach to patients with possible thrombosis and
the selection of which ones to investigate further for
underlying abnormalities.
Thus the new edition of Wintrobe can be recommended as
a good generalist textbook of clinical haematology.
MARK VI CKERS
Transfusion Therapy: Clinical Principles and Practice. Edited by
PAUL D. MINTZ. AABB Press, Bethesda, Maryland, 1999.
Pp. 467.
This book, as its title implies, is orientated towards the
clinical practice of transfusion medicine and is therefore of
primary relevance to clinicians rather than to transfusion
centre and blood bank staff. It is compact and clearly laid out
with numerous tabulations of very high quality, although
few gures. The text is well written by no fewer than 27
experts in their respective elds, well referenced and up to
date. Sections on transfusion of patients with chronic
anaemias and haemolytic anaemias are well written and
there are chapters that cover systematically platelet and
granulocyte transfusion therapy, correction of congenital
and acquired disorders of haemostasis. The other chapters
deal with transfusion in surgery, trauma, stem cell and
organ transplantation and fetuses and neonates. Appropriately
there are good descriptions of cellular immunotherapy, the
use of immunoglobulins, leucodepleted and CMV-negative
blood components, transfusion-associated graft-versus-host
disease and transfusion reactions. There is also a very
comprehensive section on brin sealants.
Putting this book to the test, I was surprised to nd that in
bone marrow transplantation patients, washed red cells
were recommended where there was recipientdonor ABO
mismatch a somewhat unusual strategy, perhaps reecting
the practice of the contributors institution. Transfusion of
FFP was somewhat loosely described within the sections on
acquired and congenital bleeding disorders. Inevitably a
book that deals with transfusion by clinical category rather
than by blood component will suffer from this kind of
omission. However, these are minor points and the book is a
real pleasure to read. Dr Dzik writes a section challenging our
views on the need for correction of haemostatic defects prior
to invasive procedures, that perhaps predictably indicates a
lack of systematic study in this area. This chapter and many
others are thought-provoking and point to whether further
information from prospective evaluations is needed.
The American Association of Blood Banks use of
electronic publishing enabled the Editor to include late
items of text and references up to 10 weeks prior to the
scheduled publication date. This is a book that I would
recommend highly to all those with an interest in the clinical
practice of transfusion medicine. It will also be of value to
laboratory and nursing staff seeking information and advice
on the patients they help to care for, and at a cost of $159 for
non-AABB members it is reasonably priced.
D. H. PAMPHI LON
British Journal of Haematology, 1999, 105, 572
572 1999 Blackwell Science Ltd