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Cancer in Children.
  1. KATE WHEELER, Consultant paediatric oncologist

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    Cancer in Children. Edited by James S Malpas. (Pp 933; £45 hardback.) Royal Society of Medicine Press, 1996. ISBN 1-85315-282-X. (Serial: British Medical Bulletin1996;52:No 4.)

    Dramatic improvements in the diagnosis, management, and final outcome of children with a malignancy have been seen over the past 30 (particularly in the last 10) years. Rather than make this slim book a comprehensive textbook on paediatric oncology, editor James Malpas has selected topics which cover areas where the recent growth of knowledge has been especially marked. In the introduction Professor Malpas outlines how treatment for these children has progressed over the 30 year period with the development of new chemotherapeutic agents and treatment schedules, and the establishment of highly organised cooperative groups running the treatment programmes. The United Kingdom Children’s Cancer Study Group (UKCCSG), formed in January 1977, now runs many of the cooperative trials in the UK. Almost all of the chapters in this book have been written by UK members of the UKCCSG. Exceptions are Rick Womer from Philadelphia who has written on childhood sarcomas, and Jose Brosard and his colleagues from Montreal Children’s Hospital who have contributed a chapter on neuroblastoma.

    New findings in the genetics and biology of neuroblastoma have led to an improved understanding of the behaviour of this wildly variable tumour. As examples, both amplification of the n-myc gene and loss of heterozygosity of chromosome 1p in neuroblastoma cells may predict a poor prognosis. The genetics of paediatric malignancies are covered in several chapters including a discussion on its importance in the origins of childhood cancer. Lymphoblastic leukaemia, non-Hodgkin’s lymphoma, acute lymphoblastic leukaemia, and paediatric myelodysplasias are all covered in separate chapters, as are brain tumours and histiocyte disorders.

    Chemotherapy is vital in treating most childhood malignancies; one chapter comprehensively covers the pharmacological and clinical aspects of new and well established paediatric anticancer agents. Other more general chapters include the epidemiological factors relevant to the incidence of childhood cancer, cancer in adolescence (which is increasingly managed by paediatricians), and of course, the last addresses the crucial area of long term survivors. As with all books containing a collection of separately written reviews some chapters are more informative than others. However, that apart, this book is packed with up-to-date information on paediatric malignancies and I recommend it to anyone involved in the care of children with cancer.