Bone-Marrow Chip Tailors Leukemia Treatment, Cutting Costs for Portugal’s SNS

Portugal’s biomedical scene has just delivered another quiet breakthrough: a tiny “bone-marrow avatar” built on an organ-on-a-chip platform is edging closer to hospital laboratories, promising to help oncologists choose the right leukemia drug on the first attempt. While the device is still in the pre-clinical lane, its makers at the spin-off MYLeukaemia already hold two fresh EU innovation trophies—and an ambitious roadmap to turn Madeira, of all places, into Europe’s next precision-oncology testbed.

At a glance

• Portuguese scientists transform a University of Porto idea into a start-up headquartered in Funchal.

• The chip recreates an individual patient’s bone-marrow micro-environment, allowing drugs to be screened ex vivo within days.

• Validation for CE-IVD certification is under way; clinical pilots with Portuguese hemato-oncology units could start in late 2026.

• The technology lands amid a wave of 13 new targeted therapies for acute myeloid leukemia (AML) since 2013 and at least 3 more expected by early 2025.

• Health-economy analysts see potential savings for the Serviço Nacional de Saúde (SNS) by avoiding ineffective first-line regimens.

Born in Porto, perfected on an island

The initial prototype emerged inside the Institute for Research and Innovation in Health (i3S), just a short walk from Porto’s Casa da Música. When two of the project’s post-docs—both Madeirans—decided to return home during the pandemic, the gadget followed them. Regional funds, plus an EU EIT Health grant, helped MYLeukaemia scale from a benchtop curiosity to a manufacturable cartridge produced in an industrial unit overlooking the Atlantic.

The move was more than sentimental. Madeira’s government has been courting biotech as an economic diversifier, offering corporate tax rates below 5% and simplified import rules for lab consumables. Those incentives allowed the team to build a clean-room facility in the island’s free-trade zone in under nine months.

How the bone-marrow avatar works

Traditional 2D cell cultures flatten leukemic cells against plastic, stripping away the spatial cues that influence drug response. The MYLeukaemia chip, roughly the size of a credit card, houses a 3D scaffold infused with patient-derived stromal cells, cytokines and extracellular matrix. When a small aspirate of bone marrow is seeded onto the device, the malignant and healthy hematopoietic cells settle into niches that mimic the body’s own architecture.

Within 96 hours, oncologists receive a heat-map showing how the clone reacts to up to 20 targeted agents or drug combinations, including FLT3 and IDH inhibitors, venetoclax + hypomethylators and experimental CAR-NK immunotherapies now entering European trials. The result is a functional read-out that complements genomic sequencing, addressing the frustrating reality that two AML patients with the same mutation often diverge dramatically in the clinic.

Where it fits in today’s leukemia arsenal

The timing could hardly be better. Europe’s hematology community is digesting data on asciminib, the first STAMP inhibitor for chronic myeloid leukemia, while phase-1 results for TERN-701 show a 64% major molecular response at 24 weeks. Meanwhile, the standard “3 + 7” chemotherapy cocktail for AML is being eclipsed by gentler HMA-Ven doublets, making room for algorithm-driven therapy selection.

Yet even the most hyped molecules work in only a subset of patients. That is where a live, patient-specific micro-environment becomes valuable: it reveals drug resistance early, sparing individuals from toxic but ineffective regimens and allowing the SNS to allocate costly biologics more rationally.

From lab bench to Portuguese clinics: the regulatory road

MYLeukaemia’s immediate hurdle is the CE-IVD mark, the European label required for any in-vitro diagnostic. Executives say the dossier should enter the notified-body queue by summer 2026, backed by multi-centre analytical validation using archived samples from Porto, Coimbra and Lisbon. If the green light arrives on schedule, pilot use in real-time treatment decisions could follow at São João Hospital before the end of 2026.

Insiders caution that reimbursement negotiations with Infarmed and the Ministry of Health will be decisive. One scenario under discussion is a “per-sample service” priced below €900, roughly the cost of a single next-generation sequencing panel.

Why it matters for Portugal’s National Health Service

Portugal records about 350 new AML cases and 140 chronic myeloid leukemia diagnoses each year. While those figures may seem modest, hematology wards in Lisbon and Porto report that nearly 30% of AML patients over 60 never proceed to transplant because first-line therapy fails to induce remission. The economic burden—extended hospital stays, antibiotics, transfusions—quickly outstrips the price of most novel agents.

If functional precision testing prevents even one prolonged ICU admission per patient cohort, the cost-benefit ratio swings in favour of adoption. The chip’s small footprint also fits the geographical reality: district hospitals without BSL-3 cell-culture rooms could mail samples overnight to Madeira, receiving digital reports before initiating therapy.

The global race for functional precision oncology

Portugal is not alone in this space. Crown Bioscience publicised its 3D bone-marrow niche models earlier this year, and teams in Glasgow and Rochester are fine-tuning bio-engineered scaffolds to study CAR-T dynamics. What sets the MYLeukaemia platform apart, according to independent analysts, is its focus on regulatory-grade reproducibility rather than academic proof-of-concept. “You can’t run a health system on artisanal widgets,” notes Dr Ana Carvalho, head of hematology at Centro Hospitalar de Coimbra. “We need something we can bill, validate and audit.”

Voices from the field

Dr Delfim Duarte, principal investigator at i3S, underscores the scientific upside: “The avatar lets us dissect how iron metabolism or stromal signaling fuels leukemic stem cells, so we’re not just testing drugs but also uncovering new targets.”

Patients’ groups are equally enthusiastic, albeit pragmatic. Margarida Pereira, spokesperson for União Leucemia Portugal, says families often endure a “try-and-wait” roller-coaster. “Anything that shortens the guesswork is welcome, but we need assurances it won’t widen the gap between mainland and island care,” she adds.

What to watch in 2026

CE-IVD decision: a positive verdict would unlock EU-wide deployment.

First head-to-head trial comparing chip-guided therapy versus standard of care at São João and Santa Maria hospitals.

Potential public-private partnership with a multinational pharma company to bundle drug access with avatar screening.

Should these milestones fall into place, Portugal could pivot from being a consumer of imported biotech to an exporter of Made-in-Portugal precision diagnostics—a small island’s answer to one of oncology’s most stubborn riddles.