This opinion article by Paul Bourgine (ULUND) offers a critical analysis of the rapidly evolving field of human bone marrow organoids (BMOs), examining both recent breakthroughs and the key challenges that remain in replicating bone marrow physiology in vitro.

Recent studies have demonstrated the possibility of generating BMO-like structures from induced pluripotent stem cells, recapitulating early stages of hematopoietic development. However, these models still lack key features of adult bone marrow, particularly in terms of stromal complexity, vascular maturity, and hematopoietic functionality. The article discusses how current BMOs reflect primarily fetal-like characteristics and outlines potential strategies to move toward adult-like and disease-relevant models. 

This perspective underscores the relevance of BMOs for studying stem cell biology, modeling hematological disorders, and enhancing preclinical drug testing, aligning with the BuonMarrow vision of developing a Bone Marrow-on-Chip platform that integrates biological and mechanical cues with real-time biosensing to study bone marrow alterations, ultimately aiming to enable early detection of lung cancer relapse.

DOI: https://doi.org/10.1016/j.tibtech.2025.05.028