AI-enhanced 3D bioprinting innovations and challenges in bone marrow organoid engineering

Bone marrow (BM) organoids represent a vital frontier for probing hematopoietic mechanisms, pathological niche remodeling, and regenerative therapeutics. Despite their potential, faithfully simulating the BM microenvironment remains a challenging bioengineering bottleneck, as conventional scaffold-based models frequently fail to capture the spatial logic, vascular perfusion, and multi-lineage cellular diversity that is essential for physiological relevance. The integration of 3D bioprinting and artificial intelligence (AI) offers a sophisticated toolkit to overcome these limitations. This review systematically delineates the biological complexities that render the BM niche exceptionally difficult to engineer and evaluates the capacity of AI-driven frameworks to optimize bioink formulation, facilitate real-time process monitoring, and decode the functional maturation of engineered constructs. Beyond technical optimization, we examine the clinical utility of these systems in disease modeling and precision medicine. Together, these advances are reshaping BM models from static structural representations into dynamic and functionally integrated systems with growing translational relevance.