Mesenchymal stem cells.

Mesenchymal stem cells are the cells most clinics sell, taken from your own fat or marrow or grown from donor cord. Twelve products are approved worldwide for narrow uses, and none for the joints, pain or anti-ageing uses most clinics advertise.[1][2]

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What are mesenchymal stem cells?

Mesenchymal stem cells are cells grown from bone marrow, fat, umbilical cord, placenta or tooth pulp that release signalling chemicals for a short time after they are injected. Despite the name, the society that defines them says to call them stromal cells, because most do not meet the test for true stem cells.[3][4]

The scientist who named them in 1991 now calls them Medicinal Signalling Cells, because they do not become new tissue. They send signals and are then cleared, and the body's own cells do any repair.[5]

A clinic's "50 million stem cells" from your own fat or marrow is a count of all the cells in the sample, not of stem cells.[6]

In the largest trial to compare them, same-day fat and marrow preparations did not contain large numbers of these cells at all, while a lab-grown cord product did.[6]

Your own cells, or lab-grown donor cells

Same-day, from your own body

Marrow from the pelvis or fat from liposuction, spun or processed in the clinic and injected the same day. Nothing is grown, so the sample contains whatever the tissue happened to hold.[6] Patients mostly call the harvest the worst part of the day.[7]

Lab-grown, usually from donors

Cells isolated, grown for weeks, checked and frozen, then thawed and given. There is no harvest from your body.[8][9]

Four commercial machines run on the same fat gave cell yields nearly 50 times apart, so cell counts from different clinics cannot be compared.[10]

How they are given

Drip

The most common route in trials, typically 100 million cells per dose.[11] Most cells are caught in the lungs on the first pass.[12]

Joint injection

Usually a single injection, guided by ultrasound in the larger trials.[6][13]

Spinal injection

A lumbar puncture, used for nerve conditions, with headache and back pain as the usual after-effects.[14]

Approved for a few narrow uses, and none of them a clinic menu

12products approved anywhere in the world, all for narrow uses such as graft-versus-host disease, a Crohn's fistula or a cartilage defectRegulator approvals to 2026[1]
48.8% vs 46.3%remission with Alofisel against placebo in its confirming trial. It was withdrawn from the EU market in December 2024.ADMIRE-CD II trial[15][16]
Noneof three cell products beat a steroid injection for knee arthritis at 12 monthsMILES trial, 480 people[6]
2 of 43patients given donor cells described seeing a quality figure for their own batchOur review of patient accounts on Reddit and forums[7]

Side effects

Across 55 randomised trials, the one side effect that stood out was fever, about two and a half times as common as in control groups, with no extra infection, clots, cancer or death.[17] Harvesting your own cells adds bruising, more so from fat than from marrow.[6] The serious harms on record come from unregulated products, including 12 patients infected by contaminated cord products in 2018.[18]

Common questions

Which source is best: bone marrow, fat or cord?

No trial has answered that for any condition.[6]

Is 100 million cells better than 25 million?

Not on current evidence. In knee arthritis, 25 million or fewer did as well as higher doses.[11][13]

Do the cells stay in my body?

No. Donor cells were barely detectable after 50 days, and autopsies found only traces, never new tissue.[23]

Questions to ask a clinic

  1. Are these my own same-day cells, or lab-grown donor cells?
  2. Is your cell count a count of stem cells, or of all cells?
  3. Which lab made them, and can I see the certificate for my batch?
  4. How many times were the cells grown and split (the passage number)?
  5. Has this product been tested for my condition?

Sources

23 references
  1. Fernández-Garza LE, et al. Mesenchymal Stem Cell Therapies Approved by Regulatory Agencies around the World. Pharmaceuticals (Basel, Switzerland), 2023. Link
  2. U.S. Food and Drug Administration. Approved Cellular and Gene Therapy Products. U.S. Food and Drug Administration, Center for Biologics Evaluation and Research, 2026. Link
  3. Horwitz EM, et al. Clarification of the nomenclature for MSC: The International Society for Cellular Therapy position statement. Cytotherapy, 2005. Link
  4. Viswanathan S, et al. Mesenchymal stem versus stromal cells: International Society for Cell & Gene Therapy (ISCT®) Mesenchymal Stromal Cell committee position statement on nomenclature. Cytotherapy, 2019. Link
  5. Caplan AI. Mesenchymal Stem Cells: Time to Change the Name! Stem Cells Translational Medicine, 2017. Link
  6. Mautner K, et al. Cell-based versus corticosteroid injections for knee pain in osteoarthritis: a randomized phase 3 trial. Nature Medicine, 2023. Link
  7. StemFinder review of first-hand patient accounts on Reddit and patient forums, 2026. Method
  8. Dominici M, et al. Minimal criteria for defining multipotent mesenchymal stromal cells. The International Society for Cellular Therapy position statement. Cytotherapy, 2006. Link
  9. Moll G, et al. Do cryopreserved mesenchymal stromal cells display impaired immunomodulatory and therapeutic properties? Stem cells (Dayton, Ohio), 2014. Link
  10. Aronowitz JA, et al. Adipose stromal vascular fraction isolation: a head-to-head comparison of four commercial cell separation systems. Plastic and Reconstructive Surgery, 2013. Link
  11. Kabat M, et al. Trends in mesenchymal stem cell clinical trials 2004-2018: Is efficacy optimal in a narrow dose range? Stem Cells Translational Medicine, 2020. Link
  12. Eggenhofer E, et al. Mesenchymal stem cells are short-lived and do not migrate beyond the lungs after intravenous infusion. Frontiers in Immunology, 2012. Link
  13. Gupta PK, et al. Efficacy and Safety of Stempeucel in Osteoarthritis of the Knee: A Phase 3 Randomized, Double-Blind, Multicenter, Placebo-Controlled Study. The American Journal of Sports Medicine, 2023. Link
  14. Cudkowicz ME, et al. A randomized placebo-controlled phase 3 study of mesenchymal stem cells induced to secrete high levels of neurotrophic factors in amyotrophic lateral sclerosis. Muscle & Nerve, 2022. Link
  15. Colombel JF, et al. Darvadstrocel in Patients With Crohn's Disease With Complex Perianal Fistulas: The ADMIRE CD II Phase 3 Randomized Trial. Gastroenterology, 2026. Link
  16. European Medicines Agency. Alofisel withdrawn from the EU market. 2024. Link
  17. Thompson M, et al. Cell therapy with intravascular administration of mesenchymal stromal cells continues to appear safe: An updated systematic review and meta-analysis. EClinicalMedicine, 2020. Link
  18. Perkins KM, et al. Notes from the Field: Infections After Receipt of Bacterially Contaminated Umbilical Cord Blood-Derived Stem Cell Products for Other Than Hematopoietic or Immunologic Reconstitution - United States, 2018. MMWR. Morbidity and Mortality Weekly Report, 2018. Link
  19. U.S. Food and Drug Administration. FDA approves remestemcel-L-rknd for steroid-refractory acute graft versus host disease in pediatric patients. 2024. Link
  20. U.S. Food and Drug Administration. 21 CFR Part 1271, Subpart A (General Provisions): sections 1271.3, 1271.10, 1271.15 and 1271.20. Electronic Code of Federal Regulations (eCFR), U.S. National Archives, 2026. Link
  21. U.S. Food and Drug Administration. Regulatory Considerations for Human Cells, Tissues, and Cellular and Tissue-Based Products: Minimal Manipulation and Homologous Use; Guidance for Industry and Food and Drug Administration Staff (July 2020). U.S. Food and Drug Administration, Center for Biologics Evaluation and Research, 2020. Link
  22. National Pharmaceutical Regulatory Agency, Ministry of Health Malaysia. Guidance Document and Guidelines for Registration of Cell and Gene Therapy Products (CGTPs) in Malaysia, Second Edition (September 2025). 2025. Link
  23. von Bahr L, et al. Analysis of tissues following mesenchymal stromal cell therapy in humans indicates limited long-term engraftment and no ectopic tissue formation. Stem cells (Dayton, Ohio), 2012. Link

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