Book Review

Abstract

Pediatric Stem Cell Transplantation Paulette Mehta (Ed). Jones and Bartlett Publishers International, 2003. ISBN 0763718556. Hematopoietic stem cell transplantation for pediatric patients has significant differences from stem cell transplantation for adult patients, including the diseases transplanted and the side-effects of transplantation. Stem cell transplantation for pediatric patients has a higher proportion of non-neoplastic diseases, especially genetic diseases, and can have profound effects on the developing organ systems of children. Pediatric Stem Cell Transplantation is a multi-author book with a focus on the unique aspect of pediatric transplantation. Among the diseases that would not be prominently mentioned in a book focusing on adult transplantation include neuroblastoma, Ewing's sarcoma, and brain tumors, as well as chapters on genetic metabolic diseases and inherited bone marrow failure syndromes. One of the unique aspects of pediatric hematopoietic stem cell transplantation is that the individuals who give consent for the transplant (the parents) are not the recipient (the child). The ethical and psychological aspects of the constellation are discussed as well as the role of counseling for both parents and siblings. About half of the chapters in the book deal with issues of basic transplantation biology and approaches to hematopoietic stem cell transplantation that are the same in adult and pediatric transplantation including histocompatibility testing, transplantation for acute leukemia and myelodysplastic syndromes, infectious complications, graft-vs.-host disease, and reduced intensity transplantation. Overall, the quality of the chapters is variable. Among the best chapters are those that deal with the social/behavioral aspects of transplantation and long-term follow-up. The choice of diseases discussed in depth is unusual, starting with neuroblastoma and Ewing's sarcoma and then only later dealing with the more common pediatric neoplastic diseases such as acute lymphoblastic leukemia and acute myelogenous leukemia. Given the central role that the transplantation of severe combined immune deficiency (SCID) and the other primary immune deficiencies have had in the development of the field of hematopoietic stem cell transplantation, the absence of a specific chapter on primary immunodeficiencies is a glaring absence although primary immunodeficiencies are briefly mentioned in Dr Robert Good's overview of hematopoietic stem cell transplantation. The lack of a reproducible format is a failing. Some chapters have multiple tables that are clear and helpful, while other chapters have no tables and only text, making them less useful to readers. Another limitation is that few chapters have references after 2001. Thus, the book has significant limitations for physicians actively involved in pediatric hematopoietic stem cell transplantation. Its greatest use will be by the nonphysician members of pediatric transplant teams interested in the nonmedical aspects of transplantation, as well as nontransplant physicians interested in a book that does not comprehensively address the unique diseases for which children undergo hematopoietic stem cell transplantation.