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Leukaemia Diagnosis (2nd ed).
  1. Peter Carey

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    By B J Bain. (£49.50.) Blackwell Science, 1998. ISBN: 0 632 051 655.

    The first edition of this book was published in 1990 with the subtitle A guide to the FAB classification. (The FAB group had by then published proposals for the classification of the acute leukaemias, the myelodysplastic syndromes and the chronic lymphoid leukaemias.) “This book is much more than an atlas,” quoted from a review of that edition, advertises this new volume from its back cover. How true. Much more than just a guide to the FAB classification too. It has been comprehensively revised and updated to include current immunophenotypic, cytogenetic, and molecular developments, and also consideration of scatterplot data from the new generation of automated counters. The book is both a comprehensive atlas of clearly reproduced photomicrographs of a whole range of common and rare leukaemic material, and an elegant and enthusiastically written treatise on leukaemia classification.

    No classification of leukaemia can be perfect. The often competing criteria of easy and reproducible applicability, clinical relevance, and biological plausibility necessitate compromises. This work does not seek to champion or defend the FAB classifications, but explains them critically, and sets them in contemporary context in the light of the newer technological developments. Cytogenetic and molecular discoveries have clarified many biological entities. Meanwhile, generations of careful morphologists, for whom Dr Bain is a contemporary standard bearer, have gone back to the microscopic appearances to find that much of the information was there for the want of looking. Thus we can predict from the preliminary appearances when we are going to find an 8;21 translocation or a 16 inversion, whether or not a Philadelphia negative case is going to be found to have a bcr rearrangement, and many more examples. For the clinical haematologist this is not only rapidly available free information, it is also fun, and there's little enough of that around these days. Even the developing “Bugger the cytochemistry, what do the markers show?” school of haematology should be enticed back to their microscopes by this enthusiastic writing, and I commend this book unreservedly to all haematologists and trainees.