Book Reviews


Platelets. Edited by Alan D. Michelson, Academic Press/Elsevier Science, New York, USA, 2002. Pp. 1000. £175, $249·95. ISBN: 0-12-493951-1.

Dr Alan Michelson should be applauded for the conception, execution and editing of this valuable and timely book. Bringing together a formidable list of no less than 108 contributing authors, all experts in their respective fields of medicine or biology, can have been no light task. The effort has certainly been worth it since this book, with its scope and depth, has much to offer clinicians, laboratory haematologists and academic researchers alike who are actively involved with platelets.

Barry Coller's foreword sets the tone of the book succinctly. He deals with a selective and brief history of the platelet which serves to remind us of the tremendous progress in our understanding of its role in medicine and biology in the previous two centuries. He starts with Bizzozero's original observations and moves through such advances as the Duke bleeding time assay, the birth of aggregometry, the discovery of platelet receptors with their associated disorders and the involvement of platelets in cancer. The article has some good historical illustrations taken from seminal works. He concludes with a glance to the future as we enter the era of transgenic mice and proteomics.

The book is then divided into eight parts, covering platelet biology (16 chapters), platelet function testing (9 chapters), platelets and disease (10 chapters) and platelet disorders (13 chapters). There are then two sections on pharmacology dealing with therapies to inhibit (5 chapters) or enhance platelet function (4 chapters), transfusion medicine (3 chapters) and finally a single chapter on gene therapy. The quality of the plates and diagrams throughout the book is excellent, complementing the text admirably. Throughout the book, the authors usefully cross reference to other chapters and sections thus avoiding unnecessary repetition. The extensive referencing – there are some 12 000 in total – by all of the authors is as near contemporary as a book of this scope and size can permit.

Dealing with each part individually, the first addresses the ‘nuts and bolts’ of the platelet. Jack Levin begins by taking us on an evolutionary journey and the following two chapters by Hartwig deal firstly with current concepts in megakaryocytopoeisis and platelet genesis – coauthored by Italiano – and then the complexity of platelet structure, with particular emphasis on its cytoskeleton. Both these chapters have some particularly good illustrations and electron micrographs. The subject of platelet turnover is covered efficiently by Batar and Dale. This is followed by five excellent reviews on platelet receptors beginning with an overview by Clemetson and continuing with chapters on the GpIb-IX-V complex, the αIIbβ3 integrin, thrombin receptors and P-selectin authored by López and Berndt, Hato and colleagues, Tolentino and Bahou, and McEver, respectively. This latter chapter also includes the topic of platelet interactions with other cells. A chapter on polymorphisms is followed by an excellent description of the molecular mechanisms involved in platelet secretion by Reed. Donna Woulfe and colleagues continue this theme in their chapter on signal transduction, drawing on cutting edge research from knock-out mice models. Thrombus formation in flowing blood is the subject of a chapter by Savage and Ruggeri. Bouchard et al approach the procoagulant function of the platelet in a detailed manner while Nieuwland and Sturk contribute a short chapter on microparticles. A useful additional chapter for any future edition in this section would be the role of platelet- and microparticle-associated tissue factor in coagulation. Sara Israels completes this part with a fine chapter on neonatal platelet function.

Part two will be of most interest to clinical laboratory scientists. It begins with a brief chapter on platelet counting followed by a reappraisal of the bleeding time method. However, I found the next chapter on platelet aggregation relatively short and facile. For many laboratories aggregometry still remains the first test of choice in the evaluation of platelet function and diagnosis of associated disorders so a few examples of abnormal aggregation traces and perhaps a diagnostic flow chart or table would have been useful additions. The editor and his colleagues supply a first-rate chapter on platelet flow cytometry, setting out guidelines, quality control issues, recommendations for prototypic antibodies and emphasizing care in the sampling and handling of blood. The next three chapters individually address the Ultegra rapid platelet function analyser, the Dade PFA-100, the DiaMed cone and plate(let) analyser and their clinical uses by Steinhubl and Kereiakes, Francis, and Varon and Savion, respectively. An updated edition of this book might need to include an objective critique on the value of these methodologies as diagnostic or screening tools as their use becomes more established. Perfusion chamber methodologies are the subject of an authoritative chapter by de Groot and Sixma. This section of the book closes with the subject of animal models by Lee and Blajchman. A suggestion for future editions of this book would be to expand this chapter to include the exciting advances in knock-out mice and the newer intravital microscopy techniques.

Part three begins with a trio of chapters on the role of platelets in vascular diseases. Goldschmidt and colleagues' review of atherosclerosis is particularly well referenced and extensive. Similarly del Zoppo addresses ischemic cerebrovascular disease and Rohrer contributes a useful chapter on peripheral vascular disease. Two very interesting chapters on diabetes mellitus and renal disease follow, then one on platelets and inflammatory diseases by Klinger. The theme of inflammation is continued by Yeaman and Bayer who deliver a fascinating chapter on the involvement of platelets in antimicrobial host defence. Tumour growth and metastasis are then dealt with by Karpatkin. The last 2 chapters address platelets and neurological disorders – the first by Li et al specifically on Alzheimer's disease and a second, more general, chapter by Gurguis and Rush about psychiatric disorders.

In the fourth part, on disorders of platelet number and function, the editor begins with a clinical approach to defects of platelet function and number that is both brief and to the point. There follow no less than seven chapters describing thrombocytopenic conditions – immune thrombocytopenia, HIV-related thrombocytopenia, heparin-induced thrombocytopenia, drug-related thrombocytopenia, thrombotic thrombocytopenic purpura, pregnancy-associated thrombocytopenia, neonatal thrombocytopenia – and followed by one on pseudothrombocytopenia. The next chapter, by Tefferi, deals with the diagnosis and management of thrombocytosis and essential thrombocythemia which has some very good plates of blood smears and bone marrow biopsies. Alan and Pacquita Nurden describe in detail the inherited platelet function disorders and include a very useful table listing the major ones. Rao's chapter on acquired platelet function disorders is extremely well referenced. This part is completed by a chapter on cardiopulmonary bypass written by Smith, Rinder and Rinder.

Part five deals with antiplatelet pharmacology and, predictably, begins with a chapter on aspirin by Awtry and Loscalzo. Gp IIb-IIIa antagonists are covered by Agah and colleagues with a timely round-up of the major clinical trials. The ADP antagonists clopidogrel and ticlopidine are the subjects of a chapter by Curtin et al and Eisert contributes one on dipyridamole, usefully outlining this drug's additional actions on the vessel wall. The section concludes with a chapter about cilostazol from Ikeda and colleagues.

In contrast to its predecessor, the sixth section on the pharmacology of therapies to augment platelet numbers and function starts with the ‘new’– a useful review on thrombopoietin by Kuter that includes background information on its physiology. The next chapter by Schwertschlag and colleagues addresses interleukin 11 followed by Cattaneo and Mannucci who describe the use of desmopressin in the treatment of platelet function disorders. A review by Poon on the emerging use of recombinant factor VIIa in platelet disorders and thrombocytopenias closes this part of the book.

Transfusion medicine is the subject of the penultimate section. Perotta and Snyder begin with a well written chapter on platelet storage. The paediatric viewpoint is provided by Angiolillo and Luban. Lee and Blajchman contribute with a chapter on platelet substitutes and preservation methodologies. A single chapter on gene therapy in the treatment of platelet diseases by Wilcox and White completes this volume.

This volume was the worthy recipient of the Best Book in Medical Science Award from the Association of American Publishers, a prize, which as I understand, is presented not just for factual content but also layout and illustration. Indeed, on all of these criteria the book becomes greater than the sum of its parts and more than succeeds in the editor's aim to be a comprehensive source on the subject. Platelets is arguably the most complete compendium available on the subject of what was once regarded as merely ‘blood dust’. The volume will make a valuable addition to haematology, departmental and institutional libraries alike as a definitive reference. As a textbook, it compares very favourably to the haemostasis gold standard work, Hemostasis and Coagulation – Basic Principles and Clinical Practice, edited by Colman et al. I am sure that like that volume, Dr Michelson's Platelets will reappear in revised form in the years to come as we continually try to unravel the mysteries of these enigmatic blood components.