Established Bloodline: The Molecular Basis of Blood Diseases, 3rd Edition
Authors: Donald Metcalf
Journal: Molecular Therapy (2001)

Any multi-authored, massive, 1000-page volume now in its third edition either has achieved a standard text status or has a very aggressive publisher. The Molecular Basis of Blood Diseases clearly has found an audience that values what it has to offer and will accept the physical effort involved in handling the book. The experienced editors have assembled an impressive group of chapter authors, all established experts in their fields, good communicators, and able to review their subjects with the ease of authority. The layout of the book is pleasing and consistent, with helpful subheadings and a generous supply of clear diagrams and figures. The book therefore offers the reader a feast of well-presented facts that are a considered and reliable compendium of knowledge at the time of writing on each of the subjects covered. Inevitably, multi-author volumes have a long gestation period and the present volume is no exception. The reader will find few references later than 1999, but this is expected. For more up-to-date accounts, readers know that journal review articles are likely to be more satisfactory. The editors identify students and academic or practicing hematologists as their major audience and they are probably correct. There are, however, important alternative potential readers. Molecular biologists and those anxious to attempt gene therapy often have a basic science background, not too much knowledge about cell biology, little specific knowledge of hematopoiesis, and no personal experience of the details of various hematopoietic diseases. Does this book seize the opportunity to correct these deficiencies? Although there is some variability between the chapters, in general, insufficient effort has been made in this volume to describe the various hematopoietic diseases. Thus, molecular biologist readers will miss an opportunity to be informed of the exact details of various disease states and what remains in need of molecular explanation. For example, the two chapters on leukemia are both excellent and succinct summaries of the molecular biology of leukemic cells, but nowhere are the cardinal features of leukemia described—the progressive expansion and clonal dominance of the leukemic population, the anemia, thrombocytopenia, and susceptibility to infections of the patients. All still need adequate molecular explanations but these cardinal features of the leukemias do need to be made clear and the problems posed. It is a familiar fact to those brought up on multi-author texts that no two authors have the same writing style, thus multi-author volumes inevitably tend to be heterogeneous. This feature is also evident in the present volume. Some authors have made the useful effort to briefly recount the history of discovery in the field while others have not. Some accounts are concise and masterly, needing only one hundred or two hundred references. Other chapters are encyclopedic and information-dense with seven hundred or eight hundred references. Dense referencing has its advocates but can still be quite idiosyncratic and does not always list the first or best of the published studies on a particular question. One also wonders whether there are really eight hundred key references for any one subject. The reference lists usefully record all authors for referenced papers, but this helpful feature is lessened by the failure of the house style to give the last page numbers. I strongly doubt whether anyone can sustain their concentration long enough to read this massive volume from cover to cover. It is a book designed for dipping and focusing on particular subjects. As expected from the history of this book, the sections dealing with hemoglobin, red cells, platelets, immunoglobulins, and blood clotting dominate the book with massive and comprehensive accounts. Other subjects appear in rather scattered locations, often with scanty apparent underlying logic. There are some curious omissions. Nowhere is there an account of the molecular basis of macrocytic anemias or pernicious anemia, the acquired understanding of which are some of the jewels of hematopoietic research. Are the editors distinguishing biochemistry from molecular biology? Similarly, why are there chapters on T- and B-cell activation but no account of graft-versus-host disease or autoimmune diseases, major hematological problems about which much has been discovered in molecular terms yet much remains to be understood? One also wonders why chemokines are discussed without mention of the molecular basis of induced cell motility. The reality of life for a clinical hematologist is to encounter diseases as a series of dynamic events such as the regeneration of hematopoietic tissues following chemotherapy or transplantation, or the complex changes sequentially occurring during a serious infection. Reasonable, if incomplete, molecular explanations of what is occurring can be constructed from the available information. However, a clinician would be hard put to reconstruct these dynamic changes from the often-fragmented information in various chapters in this book. These negative criticisms should not be taken too seriously. The volume is an outstanding series of authoritative essays and these stand on their own merits. Equally refreshing is the almost complete absence of repetition of subject material between the individual chapters. This volume will be successful and deservedly so. It is becoming a daunting task to attempt a review of each of these subjects and the authors are to be congratulated on their efforts. This is a reference book that is needed in most laboratories and clinics working on blood diseases. It has much to offer and I suspect it will join the ranks of the most frequently stolen volumes in most laboratories.