Clinical Laboratory Hematology, Volume 1

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Pearson/Prentice Hall, 2004 - Medical - 956 pages
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Clinical Laboratory Hematology is a comprehensive, yet easy-to-read text of hematology and hemostasis written for students at all levels in clinical laboratory science programs, including clinical laboratory technicians, CLT (medical laboratory technicians, NET), and clinical laboratory scientists, CIS (medical technologists, MT). Other health professional students and practitioners may also benefit from this book, including pathology residents, physician assistants, and nurse practitioners. This text replaces Textbook of Hematology published by Lea & Febiger in 1988 and by Williams & Wilkins in 1996. However this text should be considered as a brand new publication because of its wide variety of changes and enhancements. Included among these changes are the following: we have assembled an extensive team of authoritative contributing authors to write chapters on specialized subjects within their respective fields of expertise; we have developed a striking design that will be conducive to today's visually oriented student; we have developed an exciting set of learning features that will help readers grasp the content more easily; we have developed a book-specific online study guide (; and finally, we have packaged the text with a free student version of the Chronolab CD-ROM photomicrograph atlas.


Understanding hematologic/hemostatic diseases is dependent on a thorough knowledge and understanding of normal processes. Thus, the book begins with a section on normal hematopoiesis and progresses through anemias, nonmalignant and malignant leukocyte disorders. Hemostasis adheres to a similar format with normal hemostasis functions discussed first, followed by abnormalities in hemostasis.

The text is divided into sections and maybe studied by section or chapter sequence. This gives the instructor flexibility td fit the book to their specific course design. The first two sections cover an introduction to hematology and normal hematopoiesis. This includes a discussion of the cell morphology, cell cycle, and its regulation. The section includes a discussion on oncogenes emphasizing the concept that neoplasms are the result of mutations in normal genes that control cell proliferation and development. This concept is further discussed in the introduction to hematopoietic neoplasms. The third section, includes procedures that are routine and performed in most laboratories. These are included at the beginning of the book so the students will have basic laboratory test information as they proceed through the subsequent chapters on hematopoietic disorders which focus on laboratory diagnostic protocols.

The next sections cover the hematopoietic disorders and special laboratory procedures. The fourth section includes the anemias and begins with an introduction to anemia chapter. The fifth section is nonmalignant disorders of the leukocytes. The sixth section includes a discussion of special laboratory procedures that are useful in diagnosis and classification of hematopoietic neoplasms: flow cytometry, cytogenetics, and molecular diagnostics. This section may be studied before or after the seventh section on neoplastic hematopoietic disorders, depending on the reader's knowledge level of the neoplasms. If this is the reader's first exposure to the neoplasms, it may be better to cover section 7 before section 6. Alternatively, sections 6 and 7 can be integrated and studied together.

Section 8 is a study of body fluids. Body fluid analysis is often a function of the hematology laboratory, since analysis includes cell counts and review of cell morphology. As much of the analysis includes identification of cells and differentiation of malignant cells from reactive or normal cells, this section has many microphotographs.

Section 9 is a study of hemostasis. It begins with a study of normal hemostasis processes and proceeds to abnormalities that are associated with bleeding and thrombosis. Due to the high frequency of thrombotic disorders and the rapid discovery of mechanisms responsible for thrombosis, the laboratory's role in diagnosis of thrombotic disorders is expanding. Thus, an entire chapter is devoted to hypercoagulability (thrombophilia). This section also includes laboratory testing procedures for evaluation of hemostasis.

The last section includes special hematology procedures and quality assurance and safety in the laboratory. Automation in hematology and hemostasis will be supplemented on the Web page with extensive use of graphics to illustrate abnormal results and teach evaluation and interpretation of data.

The book incorporates ethical issues and management issues of test utilization and value, as well as critical testing pathways. This is the soft side of science but alerts the students to issues they will be facing in their work and communities. In many cases the laboratorian is the one who has the breadth of information needed to help make critical decisions involving the laboratory and its effective, efficient, ethical use.


This book has been designed for both CLT/MLT and CLS/MT students. Using only one textbook is beneficial and economical in laboratory science programs offering both levels. Use of the book is also helpful to programs that design articulated curricula. The CLS/MT program can be confident of the CLT's/MLT's knowledge level in hematology without doing an extensive CLT/MLT course analysis.

CLT/MLT instructors will need to communicate to their students what is expected of them. They may want their students to find the information in the text that allows them to satisfy the checklist, or they may assign particular sections to read. If not assigned specific sections, the CLT/MLT student may read more than expected which is certainly not a bad thing! The students and instructors should use the checklists to determine the material to be read.

The case study questions and checkpoints are not delineated by level. CLT/MLT students should try to answer as many of these as possible. CLT/MLT instructors should select appropriate chapters for their students. Some chapters, such as molecular techniques, cytogenetics, and flow cytometry may not be included in a CLT/MLT curriculum. Each program will need to assess what fits its particular curriculum.

CLS/MT students should be able to meet both Level I and Level II checklists in most cases, but of course there may be differences among expectations of programs. Therefore, instructors are encouraged to review the checklists to ensure their appropriateness for the course. Although all chapters are appropriate for the CLS/MT student, if the program has two levels of hematology courses, Level I and Level II, instructors may choose to use the book as for a CLT/MLT program in the first course and the remainder of the book in the second course.

In all cases the instructor should begin the course with sections 1 through 3. The remaining sections can be rearranged and used as the instructor desires. The "Background Basics" feature will help the instructor determine which concepts the student should have mastered before beginning a unit of study. This concept should help instructors customize their courses.


This text has a number of unique pedagogical features that will help the student assimilate, organize, and understand the information. Each chapter begins with a group of components intended to set the stage for the content to follow.

  • Background Basics alert students to material that should be learned or reviewed before starting the chapter. In most cases it refers readers to previous chapters to help them find the material if they want to review it.
  • Objectives are comprised of two levels of checklists: Level I for basic or essential information and Level II for more advanced information. These checklists were reviewed by clinical (medical) laboratory technician (CLT/MLT) educators who made recommendations that aimed the Level I checklists to their students. Clinical laboratory science/medical technologist (CLS/MT) educators may expect their students to meet both Level I and Level II checklists requirements.
  • Overview gives the reader an idea of the chapter content and organization.

Each chapter offers students a variety of opportunities to assess their knowledge and ability to apply it.

  • Case Study is a running case feature that first appears at the beginning of each chapter and focuses the student's attention on the subject matter that the chapter will cover. Throughout the chapter at appropriate places, additional information on the case may be given such as laboratory test results, and then questions are asked. The questions relate to the material presented in preceding sections. There is a case summary and answers to the questions in the appendix.
  • Checkpoints! are integrated throughout the chapter. These are questions that require the student to pause along the way to recall or apply information covered in preceding sections. The answers are in the appendix.
  • Summary concludes the text portion of each chapter in order to help the student bring all the material together.
  • Review Questions appear at the end of each chapter. There are two sets of questions, Level I and Level II, that are referenced to the Level I and Level II objectives checklists. Answers are in the appendix.

The page design features a number of enhancements intended to aid the learning process.

  • Bold symbolsare used within the chapter text to help the student quickly cross-reference from the tables and figures to the text.
  • A oo symbolis also used when referring the student to another chapter.
  • Figures and tablesare used liberally to help the student organize and conceptualize information. This is especially important to visual learners.
  • Algorithms(critical pathways, reflex testing pathways) are used when appropriate to help illustrate effective, cost-efficient use of laboratory tests in diagnosis.
  • The microphotographsdisplayed in the book are typical of those found in a particular disease or disorder. Students should be aware that cell variations occur and that blood and bone marrow findings will not always mimic those found in textbooks.

The book is complemented by a variety of ancillary materials designed to help instructors be more effective and students more successful.

  • Instructor's Guide— Prepared by a CLT/MLT educator together with a CLS/MT educator, this guide is designed to equip faculty with necessary teaching resources regardless of the level of instruction. Features include: suggested learning activities for each chapter, test item writing guide, introduction to Bloom's taxonomy, crossword puzzles, transparency masters for selected figures and tables, sample syllabi, and a transition grid to assist instructors in correlating the content of other texts to this text.
  • Companion Web site— This free online study guide is completely unique to the market. In addition to providing an array of assessment quizzes corresponding to each chapter of the book, the Web site presents up-to-date content in the form of "On the Horizon" features. These short essays present cutting-edge material on new research and technological advancements in the field that can be updated more frequently than the book itself. The quizzes have been developed within an automatic grading system that provides users with instant scoring once users submit their answers. Each student's quiz results can be emailed directly to the educator if desired—as part of a homework assignment. The Web site also will offer instructors the ability to put their syllabus online. Additional figures, tables, and other information are also located on the Web site.
  • CD-ROM— The book includes a free copy of the student version ofChronolab's Laboratory Hematology,a powerful database of hematological images that is useful in the educational setting and beyond. Users may purchase the full version of this database separately through Prentice Hall. More information about obtaining the full version of the Chronolab database can be found on the attached insert that appears on the last page of the book.

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