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**Autologous bone marrow-derived mesenchymal stromal cells** are an investigational, patient-specific stem-cell therapy evaluated by Universiti Kebangsaan Malaysia Medical Centre for subacute middle cerebral artery infarction. The product consists of mesenchymal stromal cells expanded from the individual patient's own bone marrow and administered by intravenous infusion. MSCs are intended to act predominantly through paracrine secretion and immunomodulation, altering the post-ischemic brain microenvironment toward reduced inflammation and tissue repair rather than through a defined single molecular target. In the registered phase 2 randomized trial, patients received 2 million cells per kilogram; treatment was reported as safe and well tolerated, with improvement in change in infarct volume but no statistically significant improvement in neurological or functional outcomes at 12 months.
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