Young NS:

Bone Marrow Failure Syndromes, 223 pp, Philadelphia, W.B. Saunders, 2000 ($125)

Bone marrow failure was first recognized in bicycle tire workers exposed to benzene in 1897. Fanconi, a Swiss pediatrician, described pancytopenia, hyperpigmentation, and skeletal malformations in three brothers in 1927. Myelodysplasia is a clonal, proliferative stem cell disorder paradoxically manifesting cytopenia. Paroxysmal nocturnal hemoglobinuria is another clonal disorder that lacks numerous molecules attached to the red blood cell membrane because of a particular glycolipid anchor defect. Thirteen experts contributing 10 chapters exhaustively describe the implications for anemia, leukopenia, and thrombocytopenia of these diverse conditions, plus others. Focused chapters review human immunodeficiency virus, Fanconi’s anemia, myelodysplasia, paroxysmal nocturnal hemoglobinuria, pure red cell aplasia, T-cell large granular lymphocyte lymphoproliferative disorder, agranulocytosis, and myelofibrosis.

Infectious, malignant, hereditary, and acquired conditions yield various cytopenias. In part, it could be suggested that bone marrow failure remains a fearful, poorly understood concept because its diverse causes are rarely considered together as a group of related syndromes. This new book should hep educate and stimulate debate. Clear line drawings illustrate relevant molecular, biochemical, and immunologic pathogenetic mechanisms. Abundant tables summarize differential diagnostic features. Perhaps of less interest to pathologists, there are also recommendations for therapy. Overall, this is an impressive reference work for a frequently confounding group of hematologic diseases.