Adult bone marrow stem cell is an ideal target for gene therapy of genetic diseases, selected malignant diseases, and AIDS. The in vivo approach of lentivirus vector (LV)-mediated stem cell gene transfer by intrafemoral (IF) injection can take full advantage of any source of stem cells residing in the bone cavity. Such an approach may avoid several difficulties encountered by ex vivo hematopoietic stem cell (HSC) gene transfer. We have shown that both HSC and mesenchymal stem/progenitor cells (MSC) can be genetically modified successfully by a single "in situ" IF injection in their natural "niche" in mice without any preconditioning. This approach may provide a novel application for treatment of human diseases, and represent an interesting new tool to study adult stem cell plasticity and the nature of unperturbed hematopoiesis.