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Book Reviews

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

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 flavour, 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 first towards electronic retrieval databases

such as Medline. Haematology is becoming ever morespecialized, 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 benefit

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being out of date can be made; for instance, the haemo-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 difficult

decision. My own opinion is that, like so many other

consumer products, it is increasingly difficult to differentiate

between the large textbooks. Notable relative weaknesseshave been identified and eliminated. I would say that

Wintrobe is better on clinical problems and correspondingly

weaker on the underlying scientific 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 flip 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 ofWintrobecan be recommended as

a good generalist textbook of clinical haematology.M A R K V I C K E R S

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 figures. The text is well written by no fewer than 27

experts in their respective fields, 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 verycomprehensive section on fibrin sealants.

Putting this book to the test, I was surprised to find that in

bone marrow transplantation patients, washed red cells

were recommended where there was recipientdonor ABO

mismatch a somewhat unusual strategy, perhaps reflecting

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 alack 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. PA M P H I L O N

British Journal of Haematology, 1999, 105, 572

572 1999 Blackwell Science Ltd