The aminothiol, amifostine (Ethyol; U.S. Bioscience, West Conshohocken, PA), is a cytoprotective agent that ameliorates the toxicities of anticancer therapy. In vitro, amifostine promotes the formation and survival of primitive hematopoietic progenitors derived from myelodysplastic bone marrow (BM) specimens. To evaluate the hematological effects of amifostine, 18 patients with myelodysplastic syndrome (MDS) and one or more refractory cytopenias received treatment with amifostine in a Phase I/II study. Four cohorts received intravenous treatment with 100, 200, or 400 mg/m2 amifostine three times a week, or 740 mg/m2 weekly for three consecutive weeks followed by 2 weeks observation. Nonresponding patients received a second course of therapy at the next higher dose level depending upon drug tolerance. Bone marrow (BM) progenitor growth was assessed before treatment and after day 21. Diagnoses included refractory anemia (7), refractory anemia with ringed sideroblasts (5), refractory anemia with excess blasts (RAEB) (4), and RAEB-in transformation (RAEB-t) (2). Single- or multi-lineage hematologic responses occurred in 15 patients (83%) treated with the three-times-a-week dose schedule. Fourteen patients had a 50% or greater increase in absolute neutrophil count with amifostine treatment (range, 426 to 11,348/μL). Platelet count increased in 6 (43%) of 14 patients with thrombocytopenia (absolute increase, 16,000 to 110,000/μL), and 5 of 15 red blood cell transfusion-dependent patients had a 50% of greater reduction in transfusion needs. Assayable hematopoietic progenitors increased in 13 of 15 evaluable patients; including CFU-GEMM (12), BFU-E (8), and CFU-GM (6). Amifostine doses less than or equal to 200 mg/m2 were well tolerated, whereas grade II nausea, vomiting, and fatigue was limiting at higher doses. Three patients with excess blasts before enrollment experienced an increase in BM blast percentage and two patients had evolution to acute leukemia that persisted after treatment withdrawal. We conclude that amifostine administered at doses ≤200 mg/m2 three times a week is well tolerated and has hematologic activity in patients with MDS.

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Reviewed by Linda C. K. Crook Modern library and information science (LIS) believes in its own neutrality, and can be oblivious to its history of racial segregation and to its current and ongoing whiteness. Topographies of Whiteness: Mapping Whiteness in Library and Information Science, edited by California State University San Bernardino librarian Gina Schlesselman-Tarango, "seeks to locate and problematize how whiteness operates" in LIS (p.1). As the first monograph bringing whiteness studies to LIS (p.3), this anthology presents a survey of the landscape, surfacing tensions rather than attempting to find resolution, and providing readers with tools to identify, name, and problematize whiteness (p.2). Schlesselman-Tarango's introduction provides an overview of critical whiteness studies and their history, as well as presenting the debates and criticisms regarding use of this framework. Whiteness studies came to the LIS field around 2001, with articles by Jody Nyasha Warner and Isabel Espinosa. This volume explores the existing landscape of research since that time as well as breaking new ground.Topographies of Whiteness brings together work by scholars and practitioners representing a diversity of perspectives, including a preface by Todd Honma and a chapter coauthored by April Hathcock, both prominent scholars of whiteness in LIS. The book is organized into three sections; the first examines the history of whiteness in LIS, the second explores the contemporary landscape of whiteness in LIS, and the third imagines possible ways of challenging and disrupting whiteness in LIS, culminating with recommendations for engagement in an anti-racist praxis.Many chapters bring critical theory to the examination of whiteness, especially critical race theory and intersectional feminism. In all cases, a good foundation to understand the theory is provided, making it accessible to readers. This much theory may come as a shock to those familiar with the literature of LIS, where there can be an overwhelming focus on the practical. For practitioners unsure if a largely theoretical work will be of use to them, this book offers the chapter, "The Whiteness of Practicality," by David James Hudson, which takes stock of the ways in which this focus on practice, and a reliance on plain language, helps white supremacy to go unchallenged in LIS. This volume is not all theory, however, and several of the authors represented in this work provide narratives of their experiences. Counterstories are an important element of Critical Race Theory, and those in this volume, such as, "My Librarianship is Not for You," by Jorge R. Lopez-McKnight, provide intimate glimpses of how it feels to move through a profession dominated by whiteness as a library worker of color.Topographies of Whiteness takes a prominent place in the literature of anti-racism in LIS. It will appeal to whiteness scholars as well as to a broad range of library workers, with sections devoted to areas of practice including archives, reference work, and LIS instruction. Although a...