Bone Marrow


The bone marrow is a highly dynamic organ located within the cavities of bones. The main role of the bone marrow is to facilitate the production of all the blood cells required for normal bodily homeostasis. These cells include lymphocytes, granulocytes, macrophages, red blood cells and plasma cells. The bone marrow is composed of many cell types that provide support for haematopoiesis, the blood cell production process. As with any major organ, many diseases can arise from errors in bone marrow function, including nonmalignant disorders such as anaemia and malignant disorders such as leukaemias. Transplantation of the bone marrow can be carried out, providing treatment options to patients suffering from bone marrow‐related disorders. This article will explore the anatomy and the role of the bone marrow, whilst providing an insight into the disorders created by errors in normal bone marrow function.

Key Concepts

  • The bone marrow is composed of red and yellow marrow and is the site of haematopoiesis.
  • The primary function of the bone marrow is haematopoiesis – haematopoietic stem cells (HSC) lead to the generation of all blood cells
  • All myeloid and lymphoid cells are generated in the bone marrow, crucial for the innate and adaptive immune systems, along with blood clotting and oxygen circulation.
  • Nonhaematopoietic cells provide key molecules to regulate the process of haematopoiesis.
  • Errors in the bone marrow can results in bone marrow‐related disorders, such as anaemia and leukaemia.

Keywords: bone marrow; haematopoiesis; myeloid; lymphoid; bone marrow protection; leukaemia; bone marrow transplants

Figure 1. A schematic representation of the bone marrow location within the bone structure. The bone marrow fills the matrix within the trabecular bone. This trabecular bone is in turn surrounded by the strong cortical bone. The epiphysis, metaphysis and diaphysis are highlighted in addition to the epiphyseal line.
Figure 2. H & E stained cross‐section of mouse femoral bone marrow, magnification 200x. CAP, capillary; EB, erythroblasts; G, granulocyte precursor; MK, megakaryocytes.
Figure 3. A schematic representation of haematopoiesis. This is the major process that occurs within the bone marrow. A single HSC (haematopoietic stem cell) gives rise to all major blood cells required for normal homeostasis. There are two major lineages of haematopoiesis; the myeloid and lymphoid lineages that give rise to cells involved in immune responses, clotting and oxygen circulation throughout the body.
Figure 4. A schematic representation of the support the bone marrow microenvironment gives to the HSCs during haematopoiesis. The number of CXCL12/SCF (stem cell factor) molecules relates to the quantity produced by the given cell. Osteoclasts do not produce membrane‐bound or soluble forms of SCF.
Figure 5. A schematic representation of the protection the bone marrow microenvironment provides to malignant cells within the bone marrow. It can be seen that a number of different bone marrow cells protect the malignancy using key signalling pathways and biological processes. This system helps the malignant cell evade standard high‐dose chemotherapy regimens.


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Further Reading

Adaptation of the Bone Marrow Stroma in Hematopoietic Malignancies ‐ Current Concepts and Models. Doron B, Handu M, Kurre P. Stem Cells. 2017 Dec 13. DOI: 10.1002/stem.2761. [Epub ahead of print] Review.

Aging, hematopoiesis, and the myelodysplastic syndromes. Chung SS, Park CY. Hematology Am Soc Hematol Educ Program. 2017 Dec 8;2017(1):73–78. DOI: 10.1182/asheducation‐2017.1.73. Review. PMID: 29222239

Clinical Implications of Bone Marrow Adiposity. Veldhuis‐Vlug AG, Rosen CJ. J Intern Med. 2017 Dec 6. DOI: 10.1111/joim.12718. [Epub ahead of print] Review. PMID: 29211319

Graft versus tumor effects and why people relapse. Falkenburg JHF, Jedema I. Hematology Am Soc Hematol Educ Program. 2017 Dec 8;2017(1): 693–698. DOI: 10.1182/asheducation‐2017.1.693. Review.

Hematopoietic development ‐ a gap in our understanding of inherited bone marrow failure. Kurre P. Exp Hematol. 2017 Dec 14. pii: S0301‐472X(17)30902‐5. DOI: 10.1016/j.exphem.2017.12.003. [Epub ahead of print] Review.

The bone marrow microenvironment ‐ Home of the leukemic blasts. Shafat MS, Gnaneswaran B, Bowles KM, Rushworth SA. Blood Rev. 2017 Sep;31(5): 277–286. DOI: 10.1016/j.blre.2017.03.004. Epub 2017 Mar 12. Review.

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Marlein, Christopher R, and Rushworth, Stuart A(Feb 2018) Bone Marrow. In: eLS. John Wiley & Sons Ltd, Chichester. [doi: 10.1002/9780470015902.a0000505.pub2]