Bone marrow derived stem cells are the most common approved medical treatment using stem cells worldwide. The first successful bone marrow transplant between two humans was performed by Dr.Donnall Thomas in 1956 and in 1990 he received a Nobel Prize in Medicine. Most people who need to undergo bone marrow transplantation have leukaemia or lymphoma. An autologous transplant involves receiving very high-dose chemotherapy followed by the infusion of your previously-collected bone marrow or peripheral blood stem cells. An allogeneic transplant involves receiving very high-doses of chemotherapy and/or radiation therapy, followed by the infusion of cryopreserved donor's bone marrow or peripheral blood stem cells. The transplanted stem cells repopulate the recipient's bone marrow and begin producing new, healthy blood cells. Although a bone marrow transplant is an effective treatment it can cause a number of different side effects including risk of bleeding, infection, graft-versus-host disease (GVHD - when the immune cells, which are part of the donated marrow attack your own body) and always is an expensive, lengthy, invasive process done under general or spinal anaesthesia, and any anaesthesia poses some risk.

BMSCs are a rare but heterogeneous population in bone marrow constituting only 0.002% of total stromal cell population. When isolated by plastic adherence and expanded ex vivo, these cells show a broad spectrum of differentiation potential (osteoblasts, adipocytes, and chondrocytes).

Experimental clinical trials have recently been initiated by several research groups, which are testing the therapeutic potential of different sources of BMSC. Thus BMSCs are considered as “universal donor” or “off the shelf” cells since a single donor may be used to produce banks of cells that may be frozen and distributed to allogeneic donors for subsequent intravenous administration. BMSCs appear to have reduced immunogenic properties and broad repertoire of secreted growth factors and cytokines with immunomodulatory potential. The currently favoured approach for usage of BMSCs in regenerative medicine combines stem cells with state-of-the-art bioengineered materials which provide suitable mechanical properties for optimal tissue development and offer the potential for enhanced control of stem cells and their secretome.

The appropriate standardization of cell isolation, expansion and administration together with rigorous preclinical investigations and clinical trials are needed to augment our understanding and clinical use of BMSCs for treatment of a multitude of diseases.