Dr. Stephen Forman: Bone marrow compensation issue misses point

December 4, 2013 | by

Bone marrow transplantation is a complex procedure used to treat blood and bone cancers and other life-threatening diseases, and it's now saving more lives than ever. But it can't save everyone. Suitable bone marrow matches simply can’t be found for enough people.

Some say that allowing donors to be financially compensated for bone marrow could solve this problem. And in fact, two years ago, a Ninth Circuit Court of Appeals ruling backed such compensation, defining bone marrow as an organ and allowing donors to receive financial benefits for bone marrow just as they can receive compensation for blood and other organs.

That ruling changed a decades-old ban as it pertained to blood marrow donations and was widely cheered as a landmark, one that would lead more people to donate bone marrow and thus save the lives of men, women and children across the country.

Now the federal Department of Health and Human Services has proposed a rule that would once again bar bone marrow donors from being compensated. The department is arguing that “altruistic donations” reduce the risk that people with contagious disease will donate tissue for financial gain.

Forbes lays out the pros and cons of each side of the issue in the article "Federal Regulation Could Redefine the Word ‘Organ,’ Jeopardize Bone Marrow Donations.” And a recent Wall Street Journal op-ed, came down clearly on the pro-compensation side, urging patients and doctors to express their opposition to the proposed rule “on moral and humanitarian grounds.”

But Stephen J. Forman, M.D., the Francis & Kathleen McNamara Distinguished Chair in Hematology and Hematopoietic Cell Transplantation at City of Hope, suggests that the op-ed fails to identify the true problem – or the solution.

Compensation is a false issue, he writes in a letter published Monday in the Wall Street Journal,  one that misses the point of how stem-cell transplantation has evolved.

“The argument that bone-marrow-donor compensation can lead to an increase in the pool of bone-marrow donors ("Rationing Bone Marrow," Review & Outlook, Nov. 25) is well-meaning in intent, but scientifically invalid.”

Forman explains that many patients have such a rare genetic makeup that offering to compensate potential donors would produce no benefit. What these patients need, he says, is more research, more advances, more investment in curative options.

"It is the funding of the science of understanding stem cells and immune tolerance that is increasing our ability to transplant all who are in need. Continued support of basic and clinical science research is what will lead to these solutions.

"The research that is being done across the U.S. and around the world in this area is helping us develop safer and more effective cures of many different disorders. The cuts to the research budget of the National Institutes of Health have the most potential to damage our ability to cure patients and not the continued ban on compensation."

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In the video above, Stephen J. Forman, M.D., the Francis & Kathleen McNamara Distinguished Chair in Hematology and Hematopoietic Cell Transplantation at City of Hope, speaks of the progress against blood and bone cancers and the bone marrow and stem cell transplantation procedures that have by now saved so many.