Additional Information
Book Details
Abstract
This textbook on haematology in the Illustrated Colour Text series is suitable for medical students, junior doctors and others needing a concise and practical introduction to the subject.
- Concise and manageable coverage of the major blood diseases and their treatment.
- Does not overload the reader with science, unlike some competing books.
- Focus is on the haematology patient and on the practical aspects of the subject.
- Makes use of the attractive features of the ICT series - double page spreads, lots of colour illustrations, summary boxes.
- Updating to take account of recenty developments in stem cell biology.
- Increased emphasis on genomic and proteomic techniques in the diagnosis of haematological malignancy.
- Use of new imaging techniques including MRI and PET.
- Description of advances in treatment of leukaemia and lymphoma and in diagnosis and management of patients with thrombophilia and venous thrombosis.
- Development of new antimicrobial agents in management of immunosuppressed patients with infection.
- New double page spread on palliative care of patients with blood disorders.
- New illustrations.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front cover | cover | ||
| Haematology | i | ||
| Copyright page | iv | ||
| Preface to the fourth edition | v | ||
| Preface to the first edition | v | ||
| Acknowledgements | v | ||
| Table of Contents | vi | ||
| Anatomy and physiology | 2 | ||
| 1 The bone marrow | 2 | ||
| The structure of the bone marrow | 2 | ||
| Haematopoiesis: the stem cell hierarchy | 2 | ||
| Regulators of haematopoiesis | 2 | ||
| 2 Red cells | 4 | ||
| Erythropoietin | 4 | ||
| Structure | 4 | ||
| Metabolism | 5 | ||
| Haemoglobin and oxygen transport | 5 | ||
| Ageing and death | 5 | ||
| 3 Neutrophils, eosinophils, basophils and monocytes | 6 | ||
| Neutrophils | 6 | ||
| Eosinophils | 7 | ||
| Basophils | 7 | ||
| Monocytes | 7 | ||
| 4 Lymphocytes | 8 | ||
| T-lymphocytes | 8 | ||
| B-lymphocytes | 8 | ||
| Natural killer (NK) cells | 9 | ||
| Changes in disease | 9 | ||
| 5 The spleen | 10 | ||
| Structure | 10 | ||
| Function | 10 | ||
| Abnormal splenic states | 10 | ||
| Asplenism and hyposplenism | 10 | ||
| Hypersplenism | 11 | ||
| 6 Haemostasis | 12 | ||
| The role of platelets | 12 | ||
| Coagulation | 12 | ||
| Regulation of coagulation | 13 | ||
| Fibrinolysis | 13 | ||
| The haematology patient | 14 | ||
| 7 History taking | 14 | ||
| History of the presenting complaint | 14 | ||
| Symptoms attributable to anaemia (low haemoglobin concentration) | 14 | ||
| Symptoms attributable to a low white cell count (leucopenia) | 14 | ||
| Symptoms attributable to a low platelet count (thrombocytopenia) | 14 | ||
| Symptoms attributable to abnormal coagulation | 14 | ||
| Symptoms attributable to infiltration by malignancy | 14 | ||
| Systemic enquiry | 15 | ||
| Past medical history | 15 | ||
| Drug history | 15 | ||
| Family history | 15 | ||
| Social history | 15 | ||
| Miscellaneous | 15 | ||
| 8 Examining the patient | 16 | ||
| Look at the patient! | 16 | ||
| General examination | 16 | ||
| Examination of the lymph nodes | 16 | ||
| Examination of the spleen | 17 | ||
| 9 Laboratory haematology I – Blood and bone marrow | 18 | ||
| The blood count | 18 | ||
| Automated haematology counters | 18 | ||
| The blood film | 18 | ||
| Bone marrow examination | 19 | ||
| Aspirate | 19 | ||
| Trephine biopsy | 19 | ||
| 10 Laboratory haematology II – Coagulation and the acute phase response | 20 | ||
| Simple tests of blood coagulation | 20 | ||
| The prothrombin time (PT) | 20 | ||
| Activated partial thromboplastin time (APTT) | 20 | ||
| Quantitation of plasma fibrinogen | 20 | ||
| Measurement of the acute phase response | 20 | ||
| ESR | 20 | ||
| Plasma viscosity | 21 | ||
| C-reactive protein (CRP) | 21 | ||
| Electrophoresis | 21 | ||
| Flow cytometry | 21 | ||
| Anaemia | 22 | ||
| 11 Introduction and classification | 22 | ||
| Definition | 22 | ||
| Prevalence | 22 | ||
| General features | 22 | ||
| Classification | 22 | ||
| Morphological classification | 22 | ||
| Aetiological classification | 22 | ||
| Management | 23 | ||
| 12 Iron deficiency anaemia | 24 | ||
| Iron | 24 | ||
| Iron deficiency | 24 | ||
| Causes | 24 | ||
| Clinical features | 24 | ||
| Diagnosis | 25 | ||
| The blood count | 25 | ||
| Confirmatory tests | 25 | ||
| Management | 25 | ||
| Investigation of underlying cause | 25 | ||
| Correction of iron deficiency | 25 | ||
| 13 Megaloblastic anaemia | 26 | ||
| Why does deficiency of vitamin B12 or folate lead to megaloblastic anaemia? | 26 | ||
| Clinical syndromes | 26 | ||
| Vitamin B12 deficiency | 26 | ||
| Pernicious anaemia | 26 | ||
| Diagnosis | 27 | ||
| Treatment | 27 | ||
| Other causes of vitamin B12 deficiency | 27 | ||
| Folate deficiency | 27 | ||
| 14 Haemolytic anaemia I – General features and inherited disorders | 28 | ||
| General features of haemolysis | 28 | ||
| Diagnosis of a haemolytic anaemia | 28 | ||
| Inherited disorders | 29 | ||
| Disorders of the red cell membrane | 29 | ||
| Hereditary spherocytosis | 29 | ||
| Hereditary elliptocytosis | 29 | ||
| Abnormalities of haemoglobin | 29 | ||
| Abnormalities of red cell metabolism | 29 | ||
| Glucose-6-phosphate dehydrogenase (G6PD) deficiency | 29 | ||
| Pyruvate kinase (PK) deficiency | 29 | ||
| 15 Haemolytic anaemia II – Acquired disorders | 30 | ||
| Autoimmune haemolytic anaemia | 30 | ||
| Classification | 30 | ||
| Clinical presentation and management | 30 | ||
| Warm autoimmune haemolytic anaemia | 30 | ||
| Cold autoimmune haemolytic anaemia | 30 | ||
| Isoimmune haemolytic anaemia | 30 | ||
| Microangiopathic haemolytic anaemia | 31 | ||
| Haemolytic uraemic syndrome (HUS) | 31 | ||
| Thrombotic thrombocytopenic purpura (TTP) | 31 | ||
| Other acquired haemolytic anaemias | 31 | ||
| 16 The thalassaemias | 32 | ||
| Classification | 32 | ||
| Clinical syndromes | 32 | ||
| α-Thalassaemias | 32 | ||
| Hb-Barts hydrops syndrome (– –/– –) | 32 | ||
| HbH disease (–α/– –) | 32 | ||
| α-Thalassaemia traits | 32 | ||
| β-Thalassaemias | 32 | ||
| β-Thalassaemia major | 32 | ||
| Thalassaemia intermedia | 33 | ||
| β-Thalassaemia trait (minor) | 33 | ||
| Prenatal diagnosis | 33 | ||
| 17 Sickle cell syndromes | 34 | ||
| Pathophysiology | 34 | ||
| Clinical syndromes | 34 | ||
| Sickle cell anaemia (HbSS) | 34 | ||
| Haemolytic anaemia | 34 | ||
| Vascular-occlusive crises | 34 | ||
| Sequestration crises | 34 | ||
| Other complications | 34 | ||
| Diagnosis | 34 | ||
| Management | 35 | ||
| Prognosis | 35 | ||
| Doubly heterozygous sickling disorders | 35 | ||
| Sickle cell trait (HbAS) | 35 | ||
| Counselling and prenatal diagnosis | 35 | ||
| Screening strategies | 35 | ||
| 18 Anaemia of chronic disease | 36 | ||
| Incidence | 36 | ||
| Pathophysiology | 36 | ||
| Diagnosis | 36 | ||
| Management | 37 | ||
| Leukaemia | 38 | ||
| 19 Introduction | 38 | ||
| Definition | 38 | ||
| Incidence | 38 | ||
| Aetiology | 38 | ||
| Genetic abnormalities | 38 | ||
| Chromosomal translocations | 38 | ||
| Chromosome deletions and additions | 38 | ||
| Submicroscopic mutations | 38 | ||
| Epigenetic mechanisms | 38 | ||
| Predisposing factors | 39 | ||
| Classification | 39 | ||
| 20 Acute myeloid leukaemia | 40 | ||
| Introduction | 40 | ||
| Classification | 40 | ||
| Clinical features | 40 | ||
| Diagnosis | 40 | ||
| Management | 41 | ||
| Supportive care | 41 | ||
| Chemotherapy and stem cell transplantation | 41 | ||
| Prognosis | 41 | ||
| 21 Acute lymphoblastic leukaemia | 42 | ||
| Classification | 42 | ||
| Clinical features | 42 | ||
| Diagnosis | 42 | ||
| 1. Blood count and film | 42 | ||
| 2. Bone marrow aspirate and trephine | 42 | ||
| 3. Cytochemistry | 42 | ||
| 4. Immunophenotyping | 42 | ||
| 5. Cytogenetics | 43 | ||
| 6. Molecular techniques | 43 | ||
| Management and outcome | 43 | ||
| General principles | 43 | ||
| ALL in children | 43 | ||
| ALL in adults | 43 | ||
| 22 Chronic myeloid leukaemia | 44 | ||
| Pathogenesis | 44 | ||
| Clinical features | 44 | ||
| Diagnosis and monitoring | 44 | ||
| Treatment | 45 | ||
| Chronic phase | 45 | ||
| Advanced disease | 45 | ||
| 23 Chronic lymphocytic leukaemia | 46 | ||
| Clinical features | 46 | ||
| Diagnosis | 46 | ||
| Staging | 46 | ||
| Management | 46 | ||
| When to start treatment | 46 | ||
| Choice of treatment | 47 | ||
| 24 Other leukaemias | 48 | ||
| Hairy cell leukaemia | 48 | ||
| Clinical features | 48 | ||
| Diagnosis | 48 | ||
| Lymphoma and myeloma | 58 | ||
| 29 Hodgkin’s lymphoma | 58 | ||
| Aetiology | 58 | ||
| Classification | 58 | ||
| Clinical presentation | 58 | ||
| Classical Hodgkin’s lymphoma | 58 | ||
| Lymphocyte predominant nodular Hodgkin’s lymphoma | 58 | ||
| Diagnosis and staging | 58 | ||
| Diagnosis | 58 | ||
| Staging | 58 | ||
| Management of classical Hodgkin’s lymphoma | 59 | ||
| Early stage disease | 59 | ||
| Advanced stage disease | 59 | ||
| Prognosis and late effects of treatment | 59 | ||
| 30 Non-Hodgkin’s lymphoma | 60 | ||
| Aetiology | 60 | ||
| Classification | 60 | ||
| Clinical presentation | 60 | ||
| Diagnosis and staging | 60 | ||
| Management and prognosis | 61 | ||
| Follicular lymphoma | 61 | ||
| Diffuse large B-cell lymphoma | 61 | ||
| Selected other lymphoma subtypes | 61 | ||
| 31 Myeloma | 62 | ||
| Introduction | 62 | ||
| Basic biology | 62 | ||
| Clinical features | 62 | ||
| Diagnosis and staging | 62 | ||
| Management and outcome | 63 | ||
| Drug therapy | 63 | ||
| Management of complications | 63 | ||
| Palliative treatment – a team approach | 63 | ||
| Waldenström’s macroglobulinaemia | 63 | ||
| Myeloproliferative neoplasms | 64 | ||
| 32 Polycythaemia | 64 | ||
| Introduction | 64 | ||
| An approach to the patient with polycythaemia | 64 | ||
| Clinical syndromes | 64 | ||
| Polycythaemia vera (PV) | 64 | ||
| Secondary polycythaemia | 65 | ||
| Idiopathic erythrocytosis | 65 | ||
| Apparent polycythaemia | 65 | ||
| 33 Essential thrombocythaemia and myelofibrosis | 66 | ||
| Essential thrombocythaemia | 66 | ||
| Clinical features | 66 | ||
| Diagnosis | 66 | ||
| Management | 66 | ||
| Myelofibrosis | 66 | ||
| Clinical features | 67 | ||
| Diagnosis | 67 | ||
| Prognosis and management | 67 | ||
| Haemostasis and thrombosis | 68 | ||
| 34 Thrombocytopenia | 68 | ||
| Causes | 68 | ||
| Clinical presentation | 68 | ||
| Clinical syndromes | 68 | ||
| Immune thrombocytopenia (ITP) | 68 | ||
| Acute ITP | 68 | ||
| Chronic ITP | 69 | ||
| Drug-induced thrombocytopenia | 69 | ||
| Post-transfusion purpura | 69 | ||
| 35 Disorders of platelet function and vascular purpuras | 70 | ||
| Laboratory testing of platelet function | 70 | ||
| Inherited disorders of platelet function | 70 | ||
| Bernard–Soulier syndrome | 70 | ||
| Glanzmann’s thrombasthenia | 70 | ||
| Other disorders | 70 | ||
| Acquired disorders of platelet function | 70 | ||
| Aspirin | 70 | ||
| Chronic renal failure | 71 | ||
| Cardiopulmonary bypass | 71 | ||
| Haematological diseases | 71 | ||
| Vascular purpuras | 71 | ||
| Inherited disorders | 71 | ||
| Hereditary haemorrhagic telangiectasia (HHT) | 71 | ||
| Inherited diseases of connective tissue | 71 | ||
| Acquired disorders | 71 | ||
| 36 Haemophilia | 72 | ||
| Haemophilia A | 72 | ||
| Clinical features | 72 | ||
| Bleeding in haemophilia | 72 | ||
| Complications of treatment | 72 | ||
| Diagnosis | 72 | ||
| Management | 72 | ||
| Treatment of bleeding | 72 | ||
| Treatment of viral infection | 73 | ||
| Gene therapy | 73 | ||
| The carrier state and genetic counselling | 73 | ||
| Haemophilia B | 73 | ||
| 37 Von Willebrand disease and other inherited coagulation disorders | 74 | ||
| Von Willebrand disease | 74 | ||
| Classification (Table 37.1 and Fig 37.3) | 74 | ||
| Clinical features | 74 | ||
| Laboratory diagnosis | 75 | ||
| Management | 75 | ||
| Other inherited coagulation disorders | 75 | ||
| Factor deficiencies | 75 | ||
| Factor VIII and factor IX deficiencies | 75 | ||
| Factor XI deficiency | 75 | ||
| Factor VII deficiency | 75 | ||
| Factor V deficiency | 75 | ||
| Factor XIII deficiency | 75 | ||
| Abnormalities of fibrinogen | 75 | ||
| 38 Acquired disorders of coagulation | 76 | ||
| Disseminated intravascular coagulation (DIC) | 76 | ||
| Vitamin K deficiency | 76 | ||
| Dietary deficiency | 77 | ||
| Malabsorption | 77 | ||
| In the newborn | 77 | ||
| Liver disease | 77 | ||
| Acquired haemophilia | 77 | ||
| 39 Thrombophilia | 78 | ||
| Which patients should be investigated for thrombophilia? | 78 | ||
| Familial thrombophilia | 78 | ||
| Factor V Leiden (FVR506Q) | 78 | ||
| Prothrombin G20210A | 78 | ||
| Protein C and S deficiencies | 78 | ||
| Antithrombin deficiency | 79 | ||
| Other forms of familial thrombophilia | 79 | ||
| Management of familial thrombophilia | 79 | ||
| Acute venous thrombosis | 79 | ||
| Other situations | 79 | ||
| Counselling | 79 | ||
| Acquired forms of thrombophilia | 79 | ||
| Antiphospholipid antibody syndrome | 79 | ||
| Other acquired forms of thrombophilia | 79 | ||
| 40 Anticoagulation and thrombolytic therapy | 80 | ||
| Anticoagulation | 80 | ||
| Heparin | 80 | ||
| Unfractionated heparin | 80 | ||
| LMW heparin | 80 | ||
| Warfarin | 80 | ||
| New oral anticoagulant agents | 81 | ||
| Thrombolytic therapy | 81 | ||
| Blood transfusion | 82 | ||
| 41 Blood groups and blood testing | 82 | ||
| The blood groups | 82 | ||
| The testing of blood | 82 | ||
| Donor blood | 82 | ||
| Testing before transfusion | 82 | ||
| Blood grouping | 82 | ||
| Antibody screening | 83 | ||
| Crossmatching | 83 | ||
| Practicalities of blood ordering | 83 | ||
| 42 Clinical practice | 84 | ||
| Red cell transfusion | 84 | ||
| Practicalities of red cell transfusion | 84 | ||
| Complications of red cell transfusion | 84 | ||
| Immediate | 84 | ||
| Delayed | 84 | ||
| Massive blood transfusion | 85 | ||
| Alternatives to allogeneic blood transfusion | 85 | ||
| Transfusion of platelets and granulocytes | 85 | ||
| Platelet transfusion | 85 | ||
| Granulocyte (neutrophil) transfusion | 85 | ||
| Transfusion of plasma and plasma products | 85 | ||
| Special situations | 86 | ||
| 43 The immunosuppressed patient | 86 | ||
| Types of infection | 86 | ||
| Bacteria | 86 | ||
| Fungi | 86 | ||
| Viruses | 86 | ||
| Prevention of infection in the immunosuppressed patient | 87 | ||
| Neutropenia | 87 | ||
| Depressed cell-mediated immunity and hypogammaglobulinaemia | 87 | ||
| Post-splenectomy | 87 | ||
| Treatment of infection | 87 | ||
| The pyrexial neutropenic patient | 87 | ||
| Treatment of specific infections | 87 | ||
| 44 Pregnancy | 88 | ||
| Haematological changes | 88 | ||
| Anaemia in pregnancy | 88 | ||
| Thrombocytopenia in pregnancy | 88 | ||
| Incidental (gestational) thrombocytopenia | 88 | ||
| ITP in pregnancy | 88 | ||
| Coagulation abnormalities in pregnancy | 89 | ||
| Thromboembolism and anticoagulant therapy | 89 | ||
| DIC in pregnancy | 89 | ||
| HELLP syndrome | 89 | ||
| 45 Paediatric haematology | 90 | ||
| Normal values | 90 | ||
| Neonatal disorders | 90 | ||
| Haemolytic disease of the newborn | 90 | ||
| Diagnosis | 90 | ||
| Management | 90 | ||
| RhD prophylaxis in RhD-negative mothers | 90 | ||
| Anaemia of prematurity | 90 | ||
| Polycythaemia in the neonate | 90 | ||
| Thrombocytopenia in the neonate | 91 | ||
| Iron deficiency in infancy | 91 | ||
| Red cell aplasia in childhood and adolescence | 91 | ||
| Diamond–Blackfan anaemia | 91 | ||
| Transient erythroblastopenia of childhood | 91 | ||
| Congenital dyserythropoietic anaemias (CDAs) | 91 | ||
| 46 Haematology in the elderly | 92 | ||
| Haematopoiesis and ageing | 92 | ||
| Anaemia | 92 | ||
| Thrombosis and anticoagulation | 92 | ||
| Haemophilia and other inherited bleeding disorders | 92 | ||
| Haematological malignancy and chemotherapy | 93 | ||
| 47 Palliative care in haematological malignancy | 94 | ||
| Palliative chemotherapy and radiotherapy | 94 | ||
| Management of cancer pain | 94 | ||
| Control of non-pain symptoms | 94 | ||
| Psychosocial oncology | 95 | ||
| Complementary therapy | 95 | ||
| 48 Systemic disease | 96 | ||
| Renal disease | 96 | ||
| Liver disease and alcohol | 96 | ||
| Malignancy | 96 | ||
| Connective tissue disorders | 96 | ||
| Infections | 97 | ||
| Infectious mononucleosis | 97 | ||
| HIV infection | 97 | ||
| 49 The developing world | 98 | ||
| Malaria | 98 | ||
| Pathogenesis | 98 | ||
| Diagnosis | 98 | ||
| Clinical features | 98 | ||
| Non-immune patient | 98 | ||
| Endemic malaria | 99 | ||
| Treatment and prophylaxis | 99 | ||
| Visceral leishmaniasis (kala-azar) | 99 | ||
| Other parasitic diseases detectable in the blood | 99 | ||
| Iron deficiency in hookworm infection | 99 | ||
| Endemic Burkitt’s lymphoma | 99 | ||
| Recent advances in haematology | 100 | ||
| 50 Molecular biology | 100 | ||
| Selected techniques used in the analysis of DNA | 100 | ||
| Polymerase chain reaction (PCR) | 100 | ||
| Fluorescence in situ hybridisation (FISH) | 100 | ||
| Comparative genomic hybridisation | 100 | ||
| Microarrays/gene profiling | 100 | ||
| Next-generation sequencing | 101 | ||
| Application of molecular biology in haematology | 101 | ||
| Carrier detection and antenatal detection in genetic disorders | 101 | ||
| Haematological malignancy | 101 | ||
| Diagnosis and classification | 101 | ||
| Minimal residual disease | 101 | ||
| Stem cell transplantation | 101 | ||
| 51 Potential advances in treatment | 102 | ||
| Targeting the microenvironment in haematological malignancy | 102 | ||
| New oral anticoagulant drugs | 102 | ||
| Gene therapy | 103 | ||
| Practical procedures | 104 | ||
| 52 Venepuncture and venous access | 104 | ||
| Taking a venous blood specimen (venepuncture) | 104 | ||
| Precautions | 104 | ||
| Common problems | 104 | ||
| Children | 105 | ||
| Venous access | 105 | ||
| Peripheral venous cannulation | 105 | ||
| Central venous cannulation | 105 | ||
| 53 Bone marrow aspiration and trephine biopsy | 106 | ||
| Bone marrow aspiration | 106 | ||
| Bone marrow trephine biopsy | 107 | ||
| Bone marrow harvesting | 107 | ||
| Appendices | 108 | ||
| Appendix I: Reference ranges in normal adults | 108 | ||
| Blood count | 108 | ||
| Acute phase response | 108 | ||
| Other | 108 | ||
| Appendix II: Selected immunophenotypic (cell surface) markers | 109 | ||
| Appendix III: International prognostic index (IPI) for non-Hodgkin’s lymphoma (NHL) | 109 | ||
| Case histories | 110 | ||
| Case 1 [pp. 24–25] | 110 | ||
| Notes to Case 1 | 110 | ||
| Case 2 [pp. 28–29] | 110 | ||
| Notes to Case 2 | 110 | ||
| Case 3 [pp. 40–41] | 110 | ||
| Notes to Case 3 | 111 | ||
| Case 4 [pp. 46–47] | 111 | ||
| Notes to Case 4 | 111 | ||
| Case 5 [pp. 72–73] | 111 | ||
| Notes to Case 5 | 111 | ||
| Case 6 [pp. 68–69] | 111 | ||
| Notes to Case 6 | 111 | ||
| Case 7 [pp. 86–87] | 112 | ||
| Notes to Case 7 | 112 | ||
| Case 8 [pp. 58–59] | 112 | ||
| Notes to Case 8 | 112 | ||
| Case 9 [pp. 78–79] | 112 | ||
| Notes to Case 9 | 112 | ||
| Case 10 [pp. 52–53] | 113 | ||
| Notes to Case 10 | 113 | ||
| Case 11 [pp. 64–65] | 113 | ||
| Notes to Case 11 | 113 | ||
| Case 12 [pp. 50–51, 84–85] | 113 | ||
| Notes to Case 12 | 113 | ||
| Case 13 [pp. 62–63] | 114 | ||
| Notes to Case 13 | 114 | ||
| Case 14 [pp. 34–35] | 114 | ||
| Notes to Case 14 | 114 | ||
| Case 15 [pp. 76–77] | 114 | ||
| Notes to Case 15 | 114 | ||
| Index | 115 | ||
| A | 115 | ||
| B | 116 | ||
| C | 117 | ||
| D | 117 | ||
| E | 118 | ||
| F | 118 | ||
| G | 118 | ||
| H | 119 | ||
| I | 120 | ||
| J | 120 | ||
| K | 120 | ||
| L | 120 | ||
| M | 121 | ||
| N | 122 | ||
| O | 122 | ||
| P | 122 | ||
| Q | 123 | ||
| R | 123 | ||
| S | 123 | ||
| T | 124 | ||
| U | 124 | ||
| V | 124 | ||
| W | 125 | ||
| Z | 125 |