Compressing the world of pediatric oncology into 188 pages is a daunting task, but Pinkerton et al. have largely succeeded. Their clinically oriented text, filled with colorful histopathology, exemplary radiology, and easy-tofollow flow diagrams, is a useful teaching tool. The hardcover book is predictably split into three sections-I: Leukaemias and lymphomas, II: Tumours of the central nervous system, and III: Solid tumours. Each chapter is broadly broken down into diagnosis, pathology, staging, therapy, instructive clinical scenarios, and dilemmas associated with recurrence.
In approaching a subject as broad as pediatric oncology, one must avoid being overly detailed but also be wary of overgeneralization. For the most part the authors succeed in maintaining this balance. However, the opening chapter on leukemias falls short. The author spends more time editorializing about 'overclassification' and 'overinterpretation' than discussing the subtypes of leukemia. For example, the seven subtypes of acute myeloid leukemia (AML) are discussed only in a figure legend. A person reading about leukemia for the first time would not realize that the cure rate for AML is worse than that for acute lymphoblastic leukemia (ALL), precluding an understanding of the basis of the chemotherapy used to treat each.
The next chapter, dedicated to high-risk and relapsed leukemias, better meets the authors goal of focusing on clinical challenges. Patients at higher risk of leukemic relapse, such as those with Ph-positive ALL, chronic myeloid leukemia, or myelodysplastic syndrome, are highlighted, and post-relapse therapy is outlined. The authors segue nicely into a discussion of types, morbidities, and outcomes of bone marrow transplantation (BMT). Much of the data presented is from European BMT databases, with very little mention of data obtained elsewhere. For instance, an isolated testicular relapse of ALL in the United States would likely be treated with chemotherapy and radiation therapy rather than with matchedsibling BMT, as is recommended in the text. Because differences exist between European and American approaches to childhood cancer, readers should keep in mind that the authors have appropriately focused on their own data.