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Bone Marrow Facts, Functions, Stem Cells, and Transplants

The Importance of Bones and Bone Marrow

Bones are made of living tissue and have important functions. They store and release minerals, protect organs, and enable us to move by providing an attachment site for muscles. Many of our bones contain cavities filled with a material called marrow, which makes vital cells for our body.

Stem cells are an important component of bone marrow. They produce some of the specialized cells that our body requires. Hematopoietic stem cells in the marrow produce our red blood cells, white blood cells, and platelets. The marrow's mesenchymal stem cells produce bone, cartilage, and fat cells (adipocytes). Bone marrow transplants are sometimes used to replace stem cells that are damaged or lost.

Red and Yellow Marrow Facts

Red marrow gets its color from the numerous blood vessels that it contains. Yellow marrow contains blood vessels too, but it also has a much larger amount of fat. This lightens its color.

During early childhood, all of the bone marrow in the body is red. At around seven years of age, yellow marrow begins to replace some of the red kind. By the time we reach adulthood, we have approximately equal amounts of each color.

In an adult, red marrow is found in the skull, scapula, vertebrae, sternum, ribs, pelvis, and the ends of the long bones in the arms and legs. Yellow marrow is found in the central cavity of the long bones, which is also known as the medullary cavity.

Introduction to Stem Cells

Stem Cells and Differentiation

Most cells in our body are specialized for a specific function. They are unable to divide in order to produce new cells. Stem cells are unspecialized and are able to divide throughout their lives. Their job is to produce our specialized cells in a process called differentiation.

A stem cell divides to make two new cells. These are sometimes identical to their parent. At the start of differentiation, however, a stem cell produces one new stem cell and a second cell that is slightly more specialized than the parent one. This slightly specialized cell is called a progenitor cell. The progenitor cell then divides to make even more specialized cells. These may in turn divide to produce cells with further specializations. The process continues until the target cells are made.

Some potential uses of stem cells to repair damage in the body

Some potential uses of stem cells to repair damage in the body

In the future, stem cells may be activated and cultured in the lab and then transplanted into the appropriate part of the body. At the moment, only bone marrow transplants are known to be helpful. The use of stem cell transplants for damaged hearts is a very active area of research, however.

Stem Cells in the Bone Marrow and the Body

Bone marrow stem cells are said to be "multipotent" because one stem cell can produce several types of target cells. The specific targets for hematopoietic stem cells are red blood cells, white blood cells, and platelets. (Platelets are actually fragments of larger cells.) The targets for mesenchymal stem cells are bone cells, cartilage cells, and adipocytes.

Under normal circumstances, blood cells are made only in red bone marrow. In an emergency, such as after the loss of a large amount of blood, yellow marrow may be converted into the red kind. This enables the marrow to make the blood cells that the body needs.

Stem cells have been found in other parts of the body in addition to bone marrow. They are generally present at low levels in these areas, however, and are often quiescent. Researchers hope that by triggering the cells to divide, they will be able to repair or replace damaged tissues in our body. The researchers are investigating the chemical signals and environmental conditions that "tell" a stem cell to activate certain genes and make a particular target cell.

This is a simplified overview of blood cell formation in the bone marrow. Red bone marrow is sometimes known as myeloid tissue.

This is a simplified overview of blood cell formation in the bone marrow. Red bone marrow is sometimes known as myeloid tissue.

Features of Hematopoietic Stem Cells

Hematopoietic stem cells in the bone marrow are also known as HSCs. They make red blood cells, which carry oxygen from our lungs to our cells, the various types of white blood cells, which fight infection, and platelets, which help blood to clot when we're wounded.

Red Blood Cells

Red blood cells live for about 120 days, many white blood cells live for only hours (although some can live for years), and platelets survive for around 8 to 10 days. These cells need to be continually replaced.

Red blood cells are also known as erythrocytes and are the most abundant cell type in blood. The bone marrow makes millions of erythrocytes every day to replace those that have died and to provide extra ones when a person's oxygen requirement increases.

White Blood Cells

There are five main types of white blood cells, or leukocytes: lymphocytes, neutrophils, eosinophils, basophils, and monocytes. B lymphocytes (or B cells) mature in the bone where they're made, while T lymphocytes (or T cells) migrate to the thymus gland to mature. The thymus gland is located in the upper part of the chest.


In order to make platelets, or thrombocytes, hematopoietic stem cells produce giant cells called megakaryocytes. These are ten to fifteen times larger than erythrocytes and have a very large nucleus. They fragment as they make platelets. Like mature erythrocytes, platelets contain no nucleus.

A magnified picture of bone marrow showing  two megakaryocytes, which are the pink cells located slightly below the center of the image.

A magnified picture of bone marrow showing two megakaryocytes, which are the pink cells located slightly below the center of the image.

Functions of Mesenchymal Stem Cells

Bone marrow also contains mesenchymal stem cells, or MSCs, which are sometimes known as stromal stem cells. These produce new bone-building cells (osteoblasts), new cartilage cells (chondrocytes), and new adipocytes. There are far fewer MSCs in bone than HSCs. Mesenchymal stem cells are still important, however. Cells resembling mesenchymal stem cells are found in other parts of the body, but it's unclear how similar their activity is to the ones in bone.

Mesenchymal stem cells from bone marrow after three weeks of lab culture.

Mesenchymal stem cells from bone marrow after three weeks of lab culture.

Bone Marrow Transplants

A bone marrow transplant may be needed when the patient's own marrow becomes damaged or fails to function properly. When donated stem cells enter the bone, they produce healthy and functioning stem cells as well as the target ones.

One problem with any type of transplant is that the recipient's body may attack and destroy the donated cells. This is why doctors look for donor cells that have membrane similarities to the patient's before they perform a transplant. The cell or plasma membrane is the outer layer of a cell. The body doesn't normally attack cells that it recognizes as "self". It distinguishes self from non-self by detecting the presence of membrane proteins.

Before a marrow transplant takes place, doctors or medical technicians test for the presence of specific proteins on the membranes of the donor cells. These proteins are called human leukocyte-assisted antigens, or HLA antigens. The more similar these proteins in a donor and a recipient, the greater the probability that a transplant will be successful.

From left to right: a red blood cell, an activated platelet or thrombocyte, and a white blood cell

From left to right: a red blood cell, an activated platelet or thrombocyte, and a white blood cell

Disorders That May Be Treated With a Bone Marrow Transplant

There are many disorders whose treatment may involve a bone marrow transplant. These include diseases in which the bone marrow fails to do its job properly, ones in which medical treatments destroy bone marrow cells, and certain inherited blood disorders in which faulty red blood cells or faulty hemoglobin are made. Three examples of conditions that may be helped by a marrow transplant are described below. A doctor will know whether a transplant is appropriate for a patient's specific situation.

Autoimmune Aplastic Anemia

Aplastic Anemia Facts

In aplastic anemia, the stem cells in the bone marrow are injured and the bone doesn't make enough blood cells. The disease may be inherited or acquired during life.

Acquired aplastic anemia is the more common disorder. It may arise due to exposure to toxins, certain medications, or certain viruses. Radiation or chemotherapy treatment for cancer may also damage or destroy bone marrow cells. In addition, it's thought that in some people aplastic anemia may be an autoimmune disease. In this type of disease, the immune system mistakenly attacks the body's own cells. Sometimes the cause of the disease is unknown.

Aplastic anemia may be temporary and disappear with no treatment. It may also be a longer lasting but mild condition. The disorder can sometimes be serious, however. It's often helped by blood transfusions. Medicines that stimulate marrow to make blood cells or that suppress an overactive immune system may also be helpful. A marrow transplant may be recommended as a treatment for severe aplastic anemia.

An illustration showing some of the many types of cells found in bone marrow

An illustration showing some of the many types of cells found in bone marrow

The normoblasts in the above illustration are immature erythrocytes. The myelocytes are immature white blood cells. A myeloplax is a large, multinucleated cell found in bone marrow.

Cancer Treatment and Bone Marrow Destruction

Some types of cancer are treated with powerful chemicals (chemotherapy) or high-dose radiation. These treatments destroy cells that divide rapidly, such as cancer ones. Bone marrow cells also divide rapidly, however, and may be destroyed by the cancer treatment. Doctors may use bone marrow transplants to restore stem cells after the cancer has been cured. There are three types of transplants.

  • In an autologous transplant, a patient receives their own stem cells, which were removed before the cancer treatment began.
  • In a syngeneic transplant, a person receives stem cells from their identical twin.
  • In an allogeneic transplant, a person receives stem cells from a relative or from an unrelated person whose cells are similar enough that they are not likely to be rejected. (Unless the donated cells are genetically identically to those of the recipient, however, there is no guarantee that rejection won't occur.)

Some types of cancer originate in the bone marrow. The treatment for these cancers may involve destruction of cancer cells followed by a stem cell transplant.

Thalassemia Facts

Thalassemia is an inherited condition in which an abnormal form of hemoglobin is made. Hemoglobin is the protein in red blood cells that attaches to oxygen and carries it around the body. Erythrocytes with abnormal hemoglobin don't work as effectively as healthy ones and tend to die earlier. A person with thalassemia may have no symptoms, mild symptoms, or serious ones, depending on the nature of the genetic problem.

Thalassemia may be treated by regular transfusions of normal blood or by folic acid supplements to encourage the formation of new erythrocytes. One problem with receiving frequent blood transfusions is that an excessively high level of iron may build up in the patient's body, since blood contains iron. The patient may need therapy to remove the iron.

Sometimes a bone marrow transplant is used as a treatment for thalassemia, especially in children with a severe form of the disease. Bone marrow transplants have helped some children with thalassemia to live normal lives. The likelihood of this happening in a specific case needs to be discussed with a doctor.

An illustration showing the complex structure of normal hemoglobin

An illustration showing the complex structure of normal hemoglobin

The information described below is given for general interest. A doctor will know about the latest technology related to bone marrow transplants and about the most appropriate way to perform a marrow donation and transplant in a particular case.

How Are a Bone Marrow Donation and Transplant Performed?

There are two ways to obtain bone marrow cells from a donor at the moment. One method is similar to donating blood and is called peripheral blood stem cell donation, or PBSC donation. The other process involves surgery.

In peripheral blood stem cell donation, the donor is given injections of a helpful chemical for four or five days to increase the number of bone marrow stem cells. Some of these cells enter the blood. Blood is then taken from the donor and the stem cells are removed by a device called an apheresis machine. After this removal, the blood is returned to the donor. The donation process takes between four and eight hours, depending on the specific way in which it's performed.

The donated cells are injected into the recipient and migrate to his or her bone marrow. This process is often referred to as a bone marrow donation, even though this term isn't accurate, since stem cells are being donated instead of bone marrow.

Marrow may also be removed from a donor's pelvis while he or she is under a general anesthetic. Since the donor is unconscious, the procedure is painless. There may be some soreness afterwards. The procedure is sometimes performed after regional anesthesia. In this state, the donor is conscious but has no feeling below the waist. Stem cells from the donated bone marrow are injected into the recipient's bloodstream and travel to their bone marrow.

Important and Potentially Helpful Research

Bone marrow transplants can be very helpful and may save lives. Sometimes problems develop, however. The body may destroy the donated cells or other complications may arise from the transplant.

Researchers are investigating ways to improve the effectiveness of marrow transplants. Their research may help to improve other types of transplants and may reveal more about the behavior of stem cells. Stem cell research is exciting and important. It may have wonderful benefits in the future.


  • Bone structure from BC Open Textbooks and Rice University
  • Stem cell basics from the National Institutes of Health (a United States organization)
  • Stem cell and bone marrow transplants from the National Health Service (a British organization)
  • Information about donating bone marrow from the U.S. Department of Health and Human Services
  • Aplastic anemia information from the Mayo Clinic
  • Thalassemia information from the U.S. National Library of Medicine

This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.

© 2013 Linda Crampton


Linda Crampton (author) from British Columbia, Canada on December 19, 2013:

Thank you very much, Pro-Hubber! I appreciate your comment.

Pro-Hubber from Florida on December 19, 2013:

wow..just wow..well researched, very informative and very interesting hub. I enjoyed reading this hub. specially the way you simplified the complicated medical terms made this hub more understandable. Thank you for sharing :)

Linda Crampton (author) from British Columbia, Canada on November 20, 2013:

Thanks, Crafty! I appreciate your comment very much.

CraftytotheCore on November 20, 2013:

This is a fantastic Hub. I love that chart up there titled Potential Uses of Stem Cells. Really in-depth research. I never knew there is different colored bone marrow! Fascinating.

Linda Crampton (author) from British Columbia, Canada on June 30, 2013:

Thank you very much for the visit and kind comment, DDE.

Linda Crampton (author) from British Columbia, Canada on June 30, 2013:

Thanks again, krushnach80.

Devika Primić from Dubrovnik, Croatia on June 30, 2013:

Most informative about Bone Marrow - Facts, Functions and Transplants, so many facts I didn't know of and you did it to perfection and enlightened me with great explanation, and to thepoint

krushnach80 on June 29, 2013:

I read your hubs...and I am a Bio student as well so it gives me pleasure when I read these hubs...keep writing

Linda Crampton (author) from British Columbia, Canada on June 29, 2013:

Thanks, krushnach80. I appreciate your visit.

krushnach80 on June 29, 2013:

Impressive hub....really impressive

Linda Crampton (author) from British Columbia, Canada on June 25, 2013:

Hi Deb. Yes, the future possibilities of stem cells are very exciting. Stem cell research could have a major effect on our lives in the future.

Deb Hirt from Stillwater, OK on June 25, 2013:

Stem cells are pretty amazing. I sure hope that we are able to see more of what they can do in the near future.

Linda Crampton (author) from British Columbia, Canada on June 24, 2013:

Thank you, drbj. I appreciate all your comments very much!

drbj and sherry from south Florida on June 24, 2013:

Excellent research here, Alicia, concerning stem cells and bone marrow transplants. Thank you for your assiduous research and well-written explanations. As always.

Linda Crampton (author) from British Columbia, Canada on June 24, 2013:

Thank you very much for the comment, Vicki. I appreciate your visit!

Vickiw on June 24, 2013:

Hello Alicia - as usual, a complicated subject simplified for us, and really good pictures further reinforce understanding. Very interesting, and great to know more about those important stem cells. Really enjoy reading your Hubs.

Linda Crampton (author) from British Columbia, Canada on June 24, 2013:

Hi, Chatkath. It's great to hear from you again! Thank you so much for the comment and the votes.

Linda Crampton (author) from British Columbia, Canada on June 24, 2013:

Thank you very much for the lovely comment, Bill!! Thanks for the vote and the share, too.

Kathy from California on June 24, 2013:

Incredible information Alicia-as usual you provide an excellent and easy to understand summary of a rather complicated process. With advanced medical procedures becoming part of every day conversation and same-day-surgeries, the more one understands the less there is to fear, hopefully! Good Job! Voted up and useful!

Bill De Giulio from Massachusetts on June 24, 2013:

Alicia, you should be teaching this stuff. You have a knack for explaining the most complicated subjects in an easy to understand manner. I don't know of anyone else who could keep me on the edge of my seat while explaining bone marrow :) Great job, I learned a lot, Voted up, shared, etc...

Linda Crampton (author) from British Columbia, Canada on June 24, 2013:

Thanks, Tom. I appreciate the comment, as well as the votes and the share!

Thomas Silvia from Massachusetts on June 24, 2013:

Hi my friend, very interesting and well researched article on bone marrow and transplants, this is all great and vital information for anyone needing this type of services. Well done !

Vote up and more !!! Sharing !

Linda Crampton (author) from British Columbia, Canada on June 23, 2013:

Thank you, Bill. l always appreciate your visits and kind comments!

Linda Crampton (author) from British Columbia, Canada on June 23, 2013:

Thank you very much, Faith Reaper. I appreciate the comment, the vote, the share and the blessings!

Bill Holland from Olympia, WA on June 23, 2013:

Again you have taken a complicated subject and made it easy for me to understand. Thank you as always and a job well done!

Faith Reaper from southern USA on June 23, 2013:

Very interesting and thorough article here on bone marrow and transplants!

Excellent write.

Voted up +++ and sharing

Blessings, Faith Reaper