The Non-Hodgkin's Lymphomas

 Second edition. Edited by Ian T. Magrath. 1149 pp. New York, Oxford University Press, 1997. $225. ISBN 0-340-55793-1


For years I have been responsible for organizing teaching materials on lymphoproliferative disease for our Division of Medical Oncology. Disappointed with the available textbooks because they are either out of date or incomplete, I have assembled hundreds of journal articles into a frequently consulted set of master references. Now, with the second edition of The Non-Hodgkin's Lymphomas, Dr. Ian Magrath has rendered my laboriously gathered collection obsolete. This multiauthored textbook profits from the unifying viewpoint of the editor throughout. His introduction weaves together the relevant concepts from basic science and clinical medicine and recounts the fascinating history of lymphoma research. That is followed by a concise account of contemporary ideas on the classification of lymphomas by Dr. Elaine Jaffe that includes a practical description of the Revised European-American Lymphoma classification scheme, which promises to be the core of a genuinely international biologically based lymphoma classification. Also in this section is a masterly discussion by Dr. Karl Lennert of the entities on the borders of the well-defined lymphoma subtypes. Part 3 deals with the science of lymphocytes and their disorders and covers basic biology, immunology, epidemiology, viral and bacterial etiologies, molecular genetics, and cytogenetics in sufficient detail to satisfy the needs even of readers with a special interest in these topics. The second half of the book begins with a brief but thorough section on the diagnosis and staging of lymphomas, followed by a general discussion of principles and modalities of treatment. The final major section describes treatment approaches to specific lymphomas, providing generally excellent coverage, especially in the chapters on the common sites of extranodal disease and the management of lymphoma in immunocompromised patients. I found Dr. Franco Cavalli's short summaries of gastrointestinal, testicular, paranasal sinus, and central nervous system lymphomas balanced and sophisticated; indeed, they contain as good discussions of these uncommon sites of involvement as I have found anywhere. However, in other chapters some unevenness is evident. For example, the most common type of lymphoma in adults, diffuse large-cell lymphoma, is given less than half as many pages of discussion as are the much less common diffuse lymphomas of childhood. The book ends with speculations on future developments in lymphoma treatment and a description of the international spectrum of lymphoproliferative diseases, reminding us in the West that lymphomas are more frequent and aggressive in much of the rest of the world. Did Dr. Magrath and his contributors get everything right? Inevitably not. The section on late effects of treatment deals mostly with children, despite the importance of this topic and the inherent differences in adults. I searched in vain for mention of body-cavity-associated lymphomas, human herpesvirus type 8, or the association between hepatitis C virus and lymphoplasmacytoid lymphoma. Although one third of all lymphomas occur in patients over the age of 70, there is no discussion of lymphoma in the elderly. The role of interferon in managing post-transplantation lymphoproliferative disease is overstated, as is the frequency of central nervous system involvement in AIDS-related lymphomas. However, these are small deficiencies alongside the impressive accomplishments throughout the book. I have discarded most of my collection of master references and send students to this new source confident that they will find excellent, current, and comprehensive discussions. Hematologists, oncologists, basic scientists with an interest in lymphoproliferative diseases, and specialists in lymphoma management should all keep a copy of this book ready to hand and consult it often. 

Joseph M. Connors, M.D. 
British Columbia Cancer Agency 
Vancouver, BC V5Z 4E6, Canada 

Email: Deborah Larson


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