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What are stem cells? Do they represent an extraordinary promise of healing? For which diseases? These and other questions revolve around the topic of stem cells, but what is the real reality? Stem cells are an extraordinary opportunity, but not yet a certainty. Today, blood tumors can be treated with blood stem cell transplants and major burns or corneal damage can be treated with skin stem cells. To treat other diseases, including neurological ones, with stem cells we still have to wait. We need to understand the potential risks and real benefits of this therapy in each individual situation; as with all potential new “primum non nocere” therapies.