This short handbook, published last year, purports to update haematologists and transplant physicians on recent advances in BMT. Given the seemingly unavoidable delays in publishing books, can a book ever achieve this goal? For example, in the chapter on unrelated donor (UD) BMT, in the section on CML there is no mention of STI571 (Glivec), the development of which has resulted in many patients with this disease deferring transplant.
Many of the nine chapters deserve individual mention. The chapter on gene transfer, written by Von Kalle and Mertelsmann, can only be admired for its technical thoroughness. The lack of real clinical achievement in this field is accurately portrayed. The Seattle UD-BMT team have written a chapter on the ‘true indications’ for this procedure. This is, in fact, a difficult task. What we know about UD-BMT is clearly stated, but there is insufficient comparison of the results of UD-BMT with alternative therapies. For example, the management of a patient with AML in CR2 is a subject of considerable controversy; this chapter does not compare the results of UD-BMT with autologous stem cell transplantation (SCT), it does not mention the role of CR1 duration, patient age, degree of match, CMV status, etc, in reaching a decision.
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