LIFE'S BLOOD

A compelling and thorough status report on bone marrow transplantation, where ``technology is shuffling...just ahead of certain death.'' Marget, a Massachusetts free-lance journalist, focuses on the work of hematologist Joel Rappeport, head of Yale's bone marrow transplant program. She tells her story largely through lengthy interviews with Rappeport's patients and/or their families (the survival rate is still only 50 percent), linking individual cases to advances in the field. Leukemia is but one of the diseases for which bone marrow transplant is offered as therapy; others are aplastic anemia, Wiskott-Aldrich syndrome, Gaucher's disease, and severe combined immunodeficiency. According to Marget, future possibilities based on the technology of bone marrow transplants include gene transfer as a therapy for various hereditary diseases, cancer, heart disease, and AIDS. Herself a bone marrow donor for her sister, Marget writes with strong feelings about Rappeport, for whom her admiration is occasionally mixed with exasperation, and she has deep empathy for his patients and their families. Indeed, her interviews with them are so extensive that at times she loses the thread of the main story as their plight takes center stage. The terrible truth about bone marrow transplantation is that though it may offer the only hope of cure, patients may die a more painful and protracted death than if transplants had not been attempted—and if they live, they may be left with devastating handicaps. Still, the underlying message here is one of hope: Although no dramatic breakthroughs are reported or projected, progress is being made and survival rates are improving. Marget gives that progress reality by reporting it in human terms.