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Dr G Dolan Director, Nottingham Haemophilia Comprehensive Care Centre

Over the past five decades there have been tremendous advances in the clinical management of haemophilia and other bleeding disorders. Such advances include the development of highly effective and safe coagulation factor concentrates, the use of effective treatment regimes such as prophylaxis and the adoption of the concept of comprehensive care for individuals with bleeding disorders. These have had a major contribution to the marked improvement in the quality of life and life expectancy for haemophilia. Despite these advances, there is still much that remains controversial, unclear or unsolved in the area of haemophilia and this book aims to provide an overview of some of the very topical issues in this area. The commissioners of this book are very fortunate to have recruited acknowledged European experts to review the key areas of haemophilia therapy, von Willebrands disease, rare bleeding disorders, inhibitor development and treatment. Karin Fijnvandraat presents a very

clear, comprehensive yet succinct overview of haemophilia, with a strong focus on the development of haemophilia therapy and a summary on the practical aspects of treatment. In complementary articles, Erik Berntorp and Cedric Hermans review the history and development of prophylaxis and discuss the use of pharmacokinetics in the adoption of tailored prophylaxis to achieve the most clinically and cost- effective way of delivering prophylaxis. There is an excellent discussion on the practical issues involved in tailored prophylaxis and an interesting introduction to the possible role of emerging factor concentrates with a longer duration of action.

The development and management of inhibitors remains a major challenge in haemophilia care and Samantha Gouw, Marijke van den Berg and Christopher Ludlam give an excellent overview on the important aspects of this area. There is a very comprehensive discussion on the development and risk factors for inhibitors, with a relevant and balanced discussion on possible roles of different therapeutic products. The series of articles concludes with a thorough and

very practical discussion on therapeutic options for patients with inhibitors. The high costs of haemophilia therapy attract scrutiny from a health economical point of view and this is often a difficult area for healthcare professionals to become fully engaged because of the complexity of some of the discussion and analyses involved. Luciana Scalone and colleagues have provided the readers with a clear and accessible overview of this topic, with particular relevance on the health economics of prophylaxis and inhibitor management.

Finally, there are excellent reviews of other bleeding disorders, namely, von Willebrands disease and the rare bleeding disorders. Pier Mannucci gives a scholarly and succinct discussion on the background and classification of von Willebrands disease and an excellent review of therapeutic products and treatment options. Paula Bolton-Maggs presents a comprehensive overview of the rare bleeding disorders with a very useful focus on factor XI deficiency.

This book succeeds very well in giving the reader a focused review of key aspects of haemophilia care and I recommend it to you. l

June 2013


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