Ralston Creek Review

Not Good News – Another Transplant

5-26-2012

It has been several weeks since I have posted any information and several people have asked about my bother Paul’s condition. This post is a bit tardy because I have been hoping that I could present some good news about a situation that is not constantly changing. Unfortunately, I can do neither.

It seems that a fairly large percentage of those who receive a stem cell transplant as treatment for myelofibrosis experience a relapse of the condition. The precise reasons for relapsing are not fully understood. It seems to me – and I am not a doctor – that the recipient’s DNA wants to keep making the kind of blood it is programmed to produce, even though that blood is defective and even though the cells for producing that blood have supposedly been destroyed by chemotherapy. The human body can do amazing things, though, including somehow resurrecting the destroyed cells.

After the transplant, Paul, like all stem cell recipients was living in a condition known as “chimerism.” That means that the transplanted cells, which have different DNA from the cells in the rest of his body were coexisitng with those other cells. As long as that coexistence was peaceful, he could lead a fairly normal and healthy life. However, when his own cells decided they wanted to move back into the bone marrow, serious problems arose and there was a relapse.

Six months after the transplant, a bone marrow biopsy showed that more than 90% of Paul’s stem cells had the DNA of the transplanted cells, so the chimerism was good. Two months later, that number had dropped to less than 60%, indicating that serious problems were developing. It seems that when such a relapse occurs the preferred initial treatment is a procedure called a “donor lymphocyte infusion.” That would entail the donor (me) donating additional lymphocyte cells which would then be infused into the recipient’s (Paul’s) blood. The theory seems to be that these white blood cells would help his immune system attack what were essentially his own cells that were trying to settle back into his bone marrow.

The donor lymphocyte infusion was approved by Paul’s medical insurance company, but another complication arose before the procedure could be scheduled. The most recent blood tests indicate that he may now be developing acute myeloid leukemia, which is a condition in which abnormal white blood cells accumulate in the bone marrow and interfere with the development of normal blood cells of all types. Since the fibrous tissue accumulating in his bone marrow because of the resurgence of his own stem cells also seriously interferes with the production of normal blood cells, the acute myeloid leukemia is a very severe complication.

The treatment that now seems to be appropriate is chemotherapy to send the leukemia into remission followed by a second complete stem cell transplant. Although I could be the donor once again, the doctors in Texas feel that there is a greater chance of success if another donor is used. My other brother, Jim, is also a very good match, so he is going to serve as the donor in the new procedure.

A paper presented by a group of German and Israeli stem cell specialist at the December 2011 meeting of the American Society of Hematology concluded donor lymphocyte infusions and/or second stem cell transplants “are effective and well tolerated salvage approaches, which result in the majority of patients in long-term freedom from disease.” (https://ash.confex.com/ash/2010/webprogram/Paper33003.html). That is good news, and we hope such long-term freedom is the outcome here.

I will update the situation as more information is forthcoming.

Transplant Update – Need for Prayers, Etc.

3-27-2012

It has been a little more than six months since my brother’s stem cell transplant. For the first five months, he made very good progress. This last month has been rough, though.

The transplant was necessary to try to cure a condition known as myelofibrosis in which the normal production of blood cells is disrupted by fibrous tissues in the bone marrow. Additional information about the condition may be found in earlier posts on this blog.

It was hoped that the transplanted normal stem cells would replace the defective stem cells in Paul’s bone marrow. Within the past few weeks, though, the defective stem cells seem to be growing back, creating what is essentially a relapse.

As I write this, Paul is back in the hospital and the doctors are trying to deal with this unhappy development. Once again, if anyone reading this feels inclined to offer prayers, positive thoughts or healing energies, that would be welcome.

Book Review: WOODY GUTHRIE, AMERICAN RADICAL

Woody Guthrie, American Radical

Although this site is called Ralston Creek Review, we have not yet published any formal reviews. That is about to change, with a review of a book by Will Kaufman, a professor of American literature and American culture at the University of Central Lancashire in England. The book. published by the University of Illinois Press in 2011, is entitled Woody Guthrie, American Radical.

Woody Guthrie is often seen as the quintessential American folksinger: a simple man hitchhiking and riding the rails, singing the songs of the common man to the workers who make this country great. We remember his songs like “Roll On Columbia,” “Pretty Boy Floyd,” “Ballad of Tom Joad” and of course “This Land is Your Land.” We see is influence in the music of Bob Dylan; Phil Ochs; Peter, Paul and Mary; Bruce Springsteen, U-2 and countless other artists. However, most of us know very little about the person he really was. Much of the legend that Guthrie’s life has become is derived from his book, Bound for Glory – which he himself called an “autobiographical novel.” It was based on his life, but was selective to the extent that it became part fiction.

John Greenway, one of my former teachers at the University of Colorado, published a book called American Folksongs of Protest back in 1970. In the final chapter of that book, Mr. Greenway devotes some 30 pages to Woody Guthrie’s life and songs and manages to convey what may be a more accurate, though acerbic, view of Guthrie’s life than what Woody himself wanted us to believe.

Will Kaufman’s book, Woody Guthrie, American Radical, is based almost entirely on Guthrie’s own writings, including many that have never been published. He was given the opportunity to review the extensive collection of the Woody Guthrie Foundation as well as those of several families with personal collections of correspondence with and about Guthrie.

The result is not a biography, but a scholarly and eye-opening look at Woody Guthrie as an entertainer whose art was influenced by his leftist political views. Woody does not seem to have ever been a member of he Communist Party, but he did write a regular column for the Party’s Daily Worker publication. He seems to have been a pacifist at heart but his strongly anti-Fascist beliefs made him a strong advocate for the entry of the United States into World War II to fight against the evil he saw represented in Adolph Hitler.

These and other little known facts are covered in great detail in this book. There are three that I would like to mention briefly in this review. The first is Guthrie’s tenure as part of the Almanac Singers, which was a group consisting originally of Woody, Pete Seeger, Millard Lampell and Lee Hays. The Almanacs began singing informally in 1940 or 1941 and continued to make music with various members (including, from time to time Burl Ives, Josh White, Sis Cunningham, Bess Lomax Hawes, Brownie McGhee, Sonny Terry and several others). They sang topical songs with folk-based melodies. Those songs were performed at union gatherings and hootenannies for the workers and the common people. Their first album of politically charged songs was widely criticized for its socialist/Communist bias, even drawing the ire of Eleanor Roosevelt. By the time their third album was released and the group was singing strongly anti-Fascist songs such as “Reuben James” and “Dear Mr. President,” Mrs. Roosevelt remarked to folklorist Alan Lomax that she had listened to the songs and “thought that they were swell.” She was even playing the record for the staff of the Office of Civilian Defense.

The next relates to the concerts that have come to be known as the “Peekskill Riots.” In the summer of 1949, actor/singer Paul Robeson had become increasingly outspoken about civil rights and critical of the Ku Klux Klan, leading to his compelled appearance before the House Un-American Activities Committee. On August 27, 1949, Robeson was scheduled to perform a concert to benefit the Civil Rights Congress at Peekskill, New York. Shortly before the concert was to begin a local mob, influenced by the Klan, attacked those in attendance with rocks and baseball bats and hanged Paul Robeson in effigy. The concert was cancelled and re-scheduled for September 4, 1949. Woody Guthrie, Pete Seeger and other socially-conscious entertainers were added to the bill for this second concert. Although there were no incidents during the performances, afterwards the local police directed the exiting traffic into an ambush. For several miles, mobs threw rocks and bottles at the departing vehicles, breaking windshields, overturning cars and beating concertgoers. The car in which Guthrie, Seeger, Seeger’s infant child and several others were riding was attacked and the window broken. Woody placed a shirt over the widow to keep the glass from shattering. Lee Hays later remembered, “Wouldn’t you know it, Woody pinned up a red shirt.”

Finally, the anecdote that seems to have generated the most interest concerns Woody’s inspiration for “This Land Is Your Land.” In 1940, Irving Berlin’s “God Bless America” was ubiquitous, playing on every radio and jukebox across the country. Woody hated the song, asking, “What ‘America’ had Kate Smith been singing of? Not the ‘big high wall’ and the painted sign saying ‘Private Property’; not the bread line ‘in the shadow of the steeple,’ by ‘the Relief Office’ where Guthrie’s ‘people…stood hungry.’ These are the first critical images in the song Guthrie initially titled ‘God Blessed America.'” Still, Woody Guthrie loved America and its people – his people – and the completed song shows that love. Like Bruce Springsteen’s “Born in the USA,” written over four decades later, what was originally meant as a strong critique of the country has been adopted as a patriotic anthem.

Woody Guthrie embraced the politics of the left and of unionism and he was radical in the ways he used his music – which he adapted from America’s folk music – to present his political views. These facts are superbly presented in Will Kaufman’s book. Woody was not a politician, however, so this book should not be seen as a definitve biography of this complex man. As John Greenway states, “Not all of Guthrie’s compositions are songs of overt protest. Of an estimated one thousand songs in his manuscript collection [now about 3000 have been collected] I found only about 140 whose basic theme is one of protest; the remainder fell into conventional folksong categories – love, humor, crime … and even nursery songs.” Woody Guthrie, American Radical presents a very detailed look at what is only one facet of the man’s work. It is well researched, well written, and certainly worth reading for anyone interested in American culture from the Dust Bowl years to the 1950s or early 1960s, or in the life and times of the radical who may truly be called “America’s Folksinger” (which was the name of his 2002 biography for elementary school students written by Karen Mueller Coombs).

Year of the Dragon – 2012

YEAR OF THE DRAGON – 2012

January 23, 2012 is the first day of the Year of the Dragon on the Chinese calendar, so it is time for my annual look at the year to come based on historical trends and Chinese astrology. I am not by any stretch of the imagination an expert on Chinese astrology, so this discussion is based on my research rather than my personal expertise. The Year of the Water Dragon will continue until February 9, 2013. It is thus apparent that the End of the World is not going to come in 2012.

The Chinese calendar is based on simple 12-year cycles, as well as larger cycles. The last Year of the Dragon was 12 years ago in 2000. At that time there was a great deal of concern about the New Millennium and Y2K, with some predicting the End of the World back then. You may have noticed that it did not end.

In the West, our mythology of the Dragon presents a fierce and dangerous beast which must be slayed by knightly heroes. The Chinese, though, see the Dragon as a benevolent creature – a symbol of power and superiority and a symbol of the ruler. The time of the Dragon is excellent for new beginnings, so we may expect a baby boom in China where many couples are planning for their children to be born during this year. Marriages that occur during a Dragon year are said to be “doubly blessed.” This is a very good thing because my daughter, Suzanne, is going to be married in July.

Another important cycle for the Chinese is the 60-year cycle. Much of Chinese philosophy is built around a belief in Five Elements – Wood, Fire, Earth, Metal and Water. Each year is said to have the attributes not only of the familiar animal, but also of one of these Elements, giving 60 different combinations (5×12=60). 2012 is the Year of the Water Dragon.

The Water Dragon is said to have a calm, visionary intelligence with an excellent balance between creativity and logic. It should be expected that the coming year will be a time for thoughtful and diplomatic progress on social and environmental issues. It may be expected that advances will be made on clean energy, energy conservation and the slowing of global warming. Since Water is the active element during the year, we could also see advances in providing clean drinking water to poverty stricken areas and to positive steps to improve the health of the world’s oceans and waterways.

This year also marks the end of a cycle of general bad luck that began back in 1996 and many will feel their luck improving. Dragon years are noted for bringing good luck to business, and especially to new ventures. These years are often times of exuberance which can lead to overspending. It is therefore important for individuals, businesses and governments to consciously set aside money for savings. Dragons are traditionally associated with Spring, which could mean that the best opportunities will arise early in the year. Watch for those and be ready to act upon them. Remember, too that the Dragon’s exuberance can also lead the unwary to spectacular failures.

As mentioned above, the major trend in a Water Dragon year should be one of calm and diplomatic progress on social and environmental issues; but that is true only to a point. The exuberance that can lead to overspending may also bring about violent discord and even revolution. Don’t be surprised if the Occupy movement, for example, becomes more visible with rallies, demonstrations and perhaps even its own counter-political convention.

Clearly, a major focus in the coming year will be the presidential election here in the United States. Even though the Year of the Dragon is auspicious for new beginnings, it is also a time favorable to rulers. Despite the general discontent with the political system and with President Obama himself, history indicates that Mr. Obama has a very good chance of being re-elected.

Because of the relationship between the 4-year presidential election cycle and the 12-year Chinese calendar, a presidential election is held during each Year of the Dragon. Since the United States was founded, there have been 18 elections held during a Year of the Dragon. An incumbent president was running for re-election in seven of those; and the incumbent won all but one or two of those times. (Andrew Jackson in 1832, a Water Dragon year; Theodore Roosevelt in 1904; Woodrow Wilson in 1916; Franklin Roosevelt in 1940; and Lyndon Johnson in 1964). The incumbent president lost in 1976 when Gerald Ford was defeated by Jimmy Carter.

The other election in which an incumbent was running was 1892 – another Water Dragon year – and that was a very strange election. In the previous election, the incumbent, Grover Cleveland, had received more of the popular vote than his opponent, Benjamin Harrison. However, Harrison won all of the large Northern states and so was chosen president through the electoral college. Cleveland and Harrison were the major candidates again in 1892, joined by two surprisingly strong third party candidates, James B. Weaver of the Populist Party and John Bidwell of the Prohibition Party. Between them, those two minor candidates received over 10% of the votes cast. The Populist Party actually carried four states, including Colorado. Once again, Grover Cleveland received the most votes; and this time he also had the most electoral votes. The winner, while not the incumbent, was the candidate who had actually received the most votes in the previous election.

Although incumbents have done well in American presidential elections, there have been major changes in governments during Dragon years. For example, it 1952 – the last Water Dragon year – Elizabeth II became Queen of England and the Dragon year 1976 saw the death of Mao Tse-Tung in China. Elizabeth’s reign has seen the transformation of the British Empire to the Commonwealth of Nations. It is probable that the role of royalty in British society will see some major changes on her passing. Nothing indicates that her passing is particularly likely this year, but there is a good chance that she could become a great-grandmother. Chairman Mao’s death led to a complete change in the very fabric of Chinese society.

Another area of focus will be the economy. During the past 60 years, the unemployment rate has dropped during each Year of the Dragon. During the last Water Dragon year, 1952, the unemployment rate dropped to 3.0%, which is the second lowest on record (the following year, 1953, the rate fell to 2.9%). The stock market has seen modest increases during most Dragon years. The glaring exception was in 2000 when the “dot-com bubble” burst and the market lost nearly 50% of its value between September and the end of the year. More typical were the previous two Dragon years, 1976 and 1988, when the market showed good recovery following crashes in the previous years. The indication, then, is that the employment situation should improve this year and the stock market should rise. The rise in the stock market may be a bit erratic with large swings both up and down.

The housing market has also improved during each Dragon year since 1952. That would indicate that the worst of the housing crisis should now be over and markets should begin to improve – perhaps slowly – this year.

Indications are that prices for precious metals should increase this year, as well.

In no particular order, here are some other things that you may occur during the Year of the Dragon:

-Like his Western cousin, the regal Chinese Dragon is a fire-breather, so we could see more than our share of volcanic eruptions and earthquakes;

-The Middle East should be more stable than it has been in recent years;

-The worldwide economy remains shaky, but the Chinese economy, particularly that of Southern China, should rebound;

-Also look for economic improvement for Canada and Russia;

-Trouble spots include Tibet, Spain and Portugal;

-Expect major advances in solar energy and in batteries or other devices for energy storage;

-Great strides are possible in stem cell research and the use of stem cell therapy to treat various diseases.

Overall, then, a year that is lucker than the past few have been. This is a time of optimism and good progress, provided that enthusiasm is kept in check and actions are taken with an eye on the future. Opportunities will certainly arise, but they may not be everything they seem at first glance.

It is a tradition in some parts of China to cook a whole fish the day before the New Year and eat most, but not all, of the fish on New Year’s Eve. Part of the fish must be saved to eat the next day, symbolizing that if we are not overly exuberant, the resources for a good life are with us even as times change. This would be a good year to practice that tradition – and if you are a vegetarian, it doesn’t need to be a fish, just something good that can be feasted upon with part saved. I hope that your luck and your opportunities, as well as your resources this year are exactly what you want and need.

Gung hay fat choy (Happy New Year)!

Time for Updates

1-17-12

I have not posted anything new for a few weeks, so it is probably time to update a couple of items.

Of course, the most important update concerns my brother’s progress since the transplant in September. Since then, there have been periods of good improvement and periods when progress seemed to have come to halt. Overall, it seems that Paul’s condition is much better than it was and the doctors are satisfied that he should keep improving. Before the transplant, he required blood transfusions every week or two simply to stay alive. It is now going on two months since his last transfusion. Recent lab work has shown that his blood counts are increasing and that the amount of fibrous tissue in his bone marrow is decreasing. Although it will be several more months before we know with certainty that the procedure was successful, we remain optimistic – and it is an optimism supported by the laboratory tests.

On another subject, I previously commented on the controversy as to whether stem cell donors should be compensated. It seemed that such compensation is prohibited by the National Organ Transplant Act of 1984 (NOTA). However, on December 1, 2011, the United States Court of Appeals for the Ninth Circuit decided a case entitled Flynn v. Holder. The court stated that peripheral stem cell transplants using cells collected from the blood through apheresis is not a procedure for which compensation is specifically prohibited by NOTA – because the procedure was not being done when the law was enacted. The court focused on the fact that although the stem cells originate in the bone marrow and are in the blood stream in large numbers only because of the Neupogen injections given to the donor, they are gathered from the blood stream and not from the marrow. Therefore, the court held that the procedure is form of blood donation for which compensation is permitted, rather than a bone marrow donation for which NOTA prohibits compensation.

There is nothing intrinsically wrong with that reasoning – and there would have been nothing intrinsically wrong if the court had gone the other way and seen the procedure as essentially a bone marrow donation. No other federal circuit has yet addressed the issue. Therefore, compensation for stem cell donations is now lawful in those jurisdictions over which the Ninth Circuit exercises appellate jurisdiction (California, Oregon, Washington, Idaho, Montana, Nevada, Arizona, Alaska, Hawaii, as well as Guam and the Northern Mariana Islands). Who knows when the issue may be considered by other circuits and whether the result will be the same.

My primary concern about permitting compensation is that I am not sure whether American patients and donors will be able to participate in international registries, possibly limiting the chances of matching appropriate donors and recipients.

Be that as it may, the most important thing to take from the post is that Paul is progressing well and we look forward to his continued improvement and to his future good health.

Happy Thanksgiving – Transplant Update

11-24-11

I am writing this on Thanksgiving Day, so I want to wish anyone who reads it a very Happy Thanksgiving, even if you are reading it on some other day.

In many ways this can be a difficult time of year, as I was reminded this morning when my daughter, Suzanne, told me that her fiancé’s grandfather passed away last night. Last year, my father passed away on the day before Thanksgiving.

Nevertheless, it is good that we have a day when we can pause and give thanks for our blessings – including the times that we have spent with family members and friends who are no longer with us.

This year, we can also be thankful that my brother seems to be doing quite well following the stem cell transplant. He had been been told that it might be necessary for him to stay in Houston until Christmas because of possible complications. Last week, though, the doctors said that is now safe for him to return to his own home in Austin. For the next few weeks he will need to return to the MD Anderson Center once each week for follow-up testing. The rest of the time he can spend at home.

Paul’s blood counts are still low, especially his red blood cells. I believe that it may be a year or more before it can be determined whether the fibrous tissue in his bone marrow will continue to be a problem. Right now we are simply thankful that he is progressing as well as he is.

We are also thankful for the support that has been provided by many people and in many ways. As an example, there is an elementary school student in Gilpin County, in the mountains West of Denver, named Sarah Trujillo. She has never met Paul, but every day for the past three months she has prayed that he will recover. You have to believe that God hears the prayers of children like her.

So — Thanks, Sarah. Thanks everyone. Happy Thanksgiving.

Payments to Stem Cell Donors

Payments to Stem Cell donors

11-8-11

Several days ago I commented on arguments that have been advanced for paying people who are willing to donate hematopoietic stem cells, a practice which is presently prohibited by federal statute (https://ralstoncreekreview.com/2011/10/ethics-and-markets-stem-cells/). I have more recently come across an article from the journal Blood published in January of this year (http://bloodjournal.hematologylibrary.org/content/117/1/21.abstract), stating the reasons why the World Marrow Donor Association continues to believe – as do I – that it is better that stem cell donors not be paid. The abstract of the article is as follows:

“Hematopoietic stem cell transplantation is a curative procedure for life-threatening hematologic diseases. Donation of hematopoietic stem cells (HSCs) from an unrelated donor, frequently residing in another country, may be the only option for 70% of those in need of unrelated hematopoietic stem cell transplantation. To maximize the opportunity to find the best available donor, individual donor registries collaborate internationally. To provide homogeneity of practice among registries, the World Marrow Donor Association (WMDA) sets standards against which registries are accredited and provides guidance and regulations about unrelated donor safety and care. A basic tenet of the donor registries is that unrelated HSC donation is an altruistic act; nonpayment of donors is entrenched in the WMDA standards and in international practice. In the United States, the prohibition against remuneration of donors has recently been challenged. Here, we describe the reasons that the WMDA continues to believe that HSC donors should not be paid because of ethical concerns raised by remuneration, potential to damage the public will to act altruistically, the potential for coercion and exploitation of donors, increased risk to patients, harm to local transplantation programs and international stem cell exchange, and the possibility of benefiting some patients while disadvantaging others. “

National Bone Marrow Awareness Month

National Marrow Awareness Month

11-1-11

I have learned that this month – November – is National Bone Marrow Awareness Month. It has not been well publicized, but I heard about this from Costco so it must be true. This is actually the second month this year to focus on bone marrow or stem cell transplants as July was African American Bone Marrow Awareness Month.

If you have read previous posts, you already know how important bone marrow or stem cell transplants are to people with certain blood disorders or cancers. Each year there are more than 10,000 patients in the United States alone who could potentially benefit from such a procedure, but it seems that appropriate donors are found for less than a third of those.

It is not easy to find a matching donor. The most likely possibility is a sibling of the person needing the transplant, but there is only about a 35% chance that the sibling will be a match. If there is not a match with a sibling, the odds become much more onerous. I have read that for a Caucasian there is only a 1 in 20,000 chance of finding a matching unrelated donor. For other ethnic groups the odds can be 1 in 100,000.

It should be obvious that the more willing donors there are, the more likely it is that an appropriate unrelated donor may be found. If you are between the ages of 18 and 60 and have any interest at all in registering as a potential donor, you may learn how to join the registry at www.marrow.org or at your local blood bank. The previous posts on this blog will give you a good idea of what is involved. Being a donor is not all that difficult, and you could save someone’s life.

Update on Transplant

10-22-11

Paul has been out of the hospital for over two weeks and has not needed a transfusion during that time – and that is the longest he has gone since March. His white blood cells remain within the normal range. His red blood cell and platelet counts are still low, but holding steady. The doctors recently biopsied his bone marrow and confirmed that the transplanted cells are, indeed, producing blood.

It is a slow process to rebuild one’s bone marrow, but Paul seems to be on course to do that.

Ethics and Markets – Stem Cells

10-19-11

A couple of recent developments have motivated me to make a few comments beyond the opinions I sometimes interject into these posts.

The first is that a friend recently asked about the ethics of stem cell transplants. Apparently the phrase “stem cell transplant” has become a kind of buzz word that unnecessarily causes emotional reactions. While there are serious ethical issues surrounding the use of embryonic stem cells for research and medical procedures, none of those issues relate to the use of stem cells such as I donated for transplant to my brother. In its statement “On Embryonic Stem Cell Research,” the United States Conference of Catholic Bishops very plainly stated: “Stem cells from adult tissues, umbilical cord blood, and placenta (often loosely called ‘adult stem cells’) can be obtained without harm to the donor and without any ethical problem, and these have already demonstrated great medical promise.”

Another ethical issue is whether donors should be paid to donate. Currently such payment is illegal under the National Organ Transplant Act (“NOTA”). In October of 2009, a lawsuit – Flynn v. Holder, CV 09 0772 – was filed in federal court in California challenging the constitutionality of the ban on such payments. The district court recently dismissed that case. The dismissal has been appealed, but for now the ban on payment remains the law.

There is a recent article in the Southern California Law Review which may be read at h ttp://lawweb.usc.edu/why/students/orgs/lawreview/documents/SCalLRev84_Young .pdf

The author, a brand new 2011 graduate of the University of Southern California Law School, argues that the ban on payments should be lifted because it would offer greater incentives for people to donate and increase the possibility that those needing transplants would find a suitable donor.

It seems, at least in my opinion, that the underlying issue is not really an ethical one or the concern for access to treatment. Rather, it is what kind of market can be created for stem cells and who is going to profit from their use. At present, I am in favor of the prohibition on compensation under NOTA which keeps the US in conformity with international standards.

That prohibition does not mean that there is not an active market in some types of stem cells, however. There are currently more than 150 companies involved in some manner in the stem cell market, some of which are publicly traded, and which offer a wide variety on ways to enter the stem cell market. Aastrom Biosciences, for instance is developing technology intended to help umbilical cord and bone marrow stem cells to replicate. Some companies like Geron have been working for several years developing therapies based on the controversial use of embryonic stem cells. Others, like Pluristem Therapeutics, Inc., have made advances utilizing less controversial placental stem cells.

I am not in any way recommending any kind of investment in any of these companies (though, in the interest of fair disclosure, I want to say that I own a small amount of stock in Pluristem). I merely want to point out, with examples, that there is already an active market in stem cells. Payment to stem cell donors, if permitted, would eventually increase the scope of that market. However, unless such payment becomes an accepted international practice, it seems a bad idea.