Hematology-Oncology Therapy

Authors:
MICHAEL M. BOYIADZIS, MD, MHSc
PETER F. LEBOWITZ, MD, PhD
JAMES N. FRAME, MD
TITO FOJO, MD, PhD, et al
Publisher:
McGraw-Hill, New York
899 pages
Price: $69.00

Reviewed by
THOMAS J. SAPHNER, MD, FACP
Principal Investigator
St. Vincent Regional Community Clinical
Oncology Program
Green Bay Oncology Clinic
St. Mary's Hospital
Medical Center
Green Bay, Wisconsin

This up-to-date, concise text is well suited to experienced practitioners who need good information fast. The text's 899 pages are well researched, demonstrating the efforts of 4 major authors and 89 contributing authors. Information is integrated from the oncology and hematology literature, practice guidelines, and the experience of the authors.

The book's 67 chapters cover oncologic and nonneoplastic hematology disorders as well as supportive care. Chapters 1 through 38 address common cancers; chapters 39 through 55 address supportive care, drug preparation, complications, and screening; and chapters 56 through 67 cover selected noncancer hematologic diseases.

The oncology chapters cover 38 cancers in a very standardized format. Common cancers such as breast, lung, colon, and prostate are covered as well as less common cancers such as carcinoid tumors, adrenocortical cancer, and pheochromocytoma. Each oncology chapter addresses epidemiology, pathology, survival, work-up, staging, caveats, and regimens. The section on caveats is the most readable and most interesting. The real value of the book is the presentation of treatment regimens in a standardized format. Each treatment regimen is accompanied by references, a description of the regimen, the patient population studied, efficacy, toxicity, and dose modifications. Nearly 500 regimens are included.

The first of 16 supportive care chapters covers nausea and vomiting, including tables categorizing the level of nausea caused by each drug and the appropriate regimen for that level. One chapter is allocated to the preparation and administration of each chemotherapeutic agent, while another discusses dose modifications. Additional chapters in this section describe the use of growth factors and bisphosphonates. Common day-to-day issues, including extravasations, catheter-related infections, venous clots, and neutropenic fevers, are also covered.

The 12 chapters on selected hematologic diseases are well suited to the medical oncologist who is consulted about nonmalignant hematology problems. Chapters include discussions of von Willebrand disease, hemophilia, heparin-induced thrombocytopenia, aplastic anemia, and idiopathic thrombocytopenic purpura. Three hematologic malignancies are also included—polycythemia vera, essential thrombocythemia, and myelodysplastic syndromes.

The book is not intended for cover-to-cover reading by the new student of oncology. Rather, this reference is useful on a day-to-day basis for referencing up-to-date information fast.

Although the authors may not have been thinking about the development of standardized care and electronic medical records, this text is well suited to achieving those ends and may be in the vanguard of references to come. Almost every study of outcomes ever done demonstrates superior results for standardized approaches to patient care. This book is ideal for standardizing office practices regarding, for example, antinausea regimens, treatment regimens, and drug preparation. Early adapting oncology practices are already converting to electronic medical records, and soon all oncology care will be given with the aid of such computerized systems. The standardized descriptions in this text will be particularly useful for practices translating a large number of regimens into electronic files.

—Thomas Saphner, MD, FACP