Book Review

Scientific Basis of Transfusion Medicine: Implications for Clinical Practice

N Engl J Med 1994; 331:1724December 22, 1994

Article

Scientific Basis of Transfusion Medicine: Implications for Clinical Practice
Edited by Kenneth C. Anderson and Paul M. Ness. 929 pp., illustrated. Philadelphia, W.B. Saunders, 1994. $115. ISBN: 0-7216-3302-1

This new textbook blends coverage of blood banking, transfusion medicine, and hematology. The usual technical details relevant to the provision of blood and blood products are distinctly absent. Instead, an impressive group of contributors has created a book that has appeal for both the transfusion-medicine specialist and the practicing physician who transfuses blood and blood products.

The initial section deals with the production of the various cellular elements and the influence of growth factors on the biology of hematopoiesis. This information is well summarized and well presented by outstanding authors, and the section reads like a hematology textbook. This section is followed by detailed discussions of cellular and humoral immunity, complement, plasma proteins, and transfusion genetics. That the reader moves from the concepts of immunohematology to the manufacture of plasma protein products is indicative of the book's merging of two disciplines, hematology and transfusion medicine. This blend is evident throughout the book. Chapters on cellular structure and function are accompanied by discussions of antigen-antibody interaction. Thus, the reader is enabled to understand the storage and transfusion characteristics of red cells, granulocytes, and platelets.

The actual amino acid changes in proteins are correlated with the serologic findings that have been described over the past 40 years, whenever this information is available. The genes identified to date are enumerated. Sections on transplantation and neonatal transfusion are followed by extensive sections on the immune effects of blood transfusion and disease transmission by blood and blood products. The final section deals with emerging forms of technology, both diagnostic and therapeutic. This last section is of particular interest. It summarizes the newest methods, including the polymerase chain reaction, and ends with applications of the new techniques to somatic gene therapy.

The book contains a large number of figures and tables, which are simply done but easy to follow and clear. Most chapters contain brief historical overviews; these vary in depth but are delightful additions to some chapters. The references are extensive but are mainly confined to material published before 1993. Chapter references are in several different styles. As in any multiauthored book, the individual chapters vary tremendously, but the overwhelming majority are superbly done. In some instances the bias of the author is clear, but all have attempted to present the relevant arguments accurately.

In summary, this excellent new textbook blends molecular biology and hematology with the practical aspects of transfusion medicine and the use of blood and blood products. The result is an exciting work that makes a major contribution to the literature in this field.

Eugene Berkman, M.D.
New England Medical Center, Boston, MA 02111