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Banking on patient donations for leading-edge leukemia research

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Hamilton Health Sciences hematologist and researcher Dr. Tobias Berg leads a research team dedicated to improving outcomes for people diagnosed with acute myeloid leukemia.

Hamilton Health Sciences (HHS) hematologist Dr. Tobias Berg is passionate about translational research, where discoveries in the lab lead to treatments that prolong and save lives. Berg leads a research team dedicated to improving outcomes for people diagnosed with acute myeloid leukemia (AML), a rare type of cancer that starts in the blood-forming cells of the bone marrow.

“We’re very open to collaborating locally, provincially, nationally and internationally.” — Dr. Tobias Berg.

Vital supporters of this leading-edge research include hundreds of HHS blood cancer patients, including many with AML and multiple myeloma, who volunteer to provide cell samples to the HHS McMaster Cancer Research Stem Cell Bank.

A researcher wearing blue gloves stores AML samples in a special freeser

AML samples from patients are stored in a special freezer at very low temperatures (-150 °C).

Samples are taken during medical procedures related to their care, such as blood being drawn or bone marrow biopsies.

“Patients undergoing certain procedures as part of their care plan may be asked if they would be willing to have a small part of their sample go towards research,” says Berg. “So no additional procedure is needed in order to collect samples.”

The cell bank currently collects approximately 100 samples per year, from over 50 patients per year. Most patients are keen to donate. “In fact, I’ve rarely experienced anyone saying no,” says Berg. “It’s very important to these patients that they have opportunities to contribute to advancements through research that could prolong future patients’ lives.”

“Dr. Berg is an outstanding researcher and a caring physician whose leadership is improving outcomes for cancer patients.” — Dr. Marc Jeschke, HHS vice president of research and chief scientific officer.

Berg spends half his work week leading research into AML at the Berg Research Lab at the Centre for Discovery in Cancer Research at McMaster University, where he is senior scientist and leads the translational oncology program. This program acts as a bridge between basic scientists and clinicians working to improve the lives of patients affected by cancer. He’s also a scientist with the Escarpment Cancer Research Institute (ECRI), a joint institute of HHS and McMaster University. Based at HHS Juravinski Hospital and Cancer Centre, ECRI’s work focuses on research that has an impact on patient outcomes.

The other half of Berg’s time is spent caring for patients as a hematologist at HHS Juravinski Hospital and Cancer Centre.

Berg started expanding the existing cell bank after arriving in Hamilton from Germany in 2019, as the inaugural Boris Family Chair in Leukemia and Hematopoietic Stem Cell Translational Research at McMaster.

“Dr. Berg is an outstanding researcher and a caring physician whose leadership is improving outcomes for cancer patients,” says Dr. Marc Jeschke, vice president of research and chief scientific officer for HHS. “Dr. Berg has also been instrumental supporting leading-edge research through his commitment to expanding the cell bank.”

Many diseases in one cancer

AML cells under the microscope.

AML cells under the microscope.

While AML is a rare cancer, it’s the most common type of acute leukemia in adults. The most effective treatment, which offers a potential cure, is an allogeneic stem cell transplant where the patient receives stem cells from a donor. Even with a transplant, relapse is unfortunately common. Due to certain pre-existing conditions, not all AML patients qualify for a transplant which leads to a less than 30 per cent chance of long-term survival with this disease.

That’s why research into prolonging patients’ lives is so vital.

Improving outcomes

While AML is considered one type of cancer, it’s actually many different diseases because patients have fairly unique combinations of mutations that occur and drive the disease.

“So it’s important to understand, through research, the biology of these subgroups and mutations in order discover the most appropriate treatment for every individual patient,” says Berg, who analyses the metabolism of diseased cells and how they interact with the immune system in order to understand why relapse is so common and find more effective treatments for managing care after a transplant to prevent a reoccurrence.

One starting point is how to deal with minimal residual disease, which refers to a small number of cancer cells often left in the body after cancer treatment, such as a stem cell transplant. Researchers try and determine why these cells can survive treatment, and why they may even continue to grow and mutate after treatment, causing a relapse.

“In order to better treat minimal residual disease, we need to understand how leukemia cells become resistant to treatment,” says Berg.

Where do leukemia cells get their energy?

“We do this by analyzing the metabolism of diseased cells and how they interact with the immune system,” he says. “We look at where leukemia cells derive their energy from and see how our treatments change this process. Since relapse after a transplant often happens when diseased cells become invisible for the immune system, we also try to understand how they get recognized by the immune system. As the donor’s immune system is a key part of the transplant, we study how we can improve the way the immune system can recognize the leukemia cells.”

Berg and his team are initiating a novel approach to understand how genes are regulated on a single-cell level. “We are doing these single cell studies with a new technology we got running with funding from the Marta and Owen Boris Foundation,” says Berg, adding he’s grateful for ongoing support from the foundation, without which none of this research would be possible, as well as funding from other organizations including the Ontario Institute for Cancer Research and the Hamilton Health Sciences Foundation.

Berg recently also received funding from the Leukemia and Lymphoma Society of Canada to explore how healthy cells surrounding cancerous ones contribute to resistance of the diseased cells, and which treatments this could be blocked with. “We are particularly interested in changes in the cancerous cells’ energy production that occur due to this interaction with surrounding cells,” says Berg.

Opportunities for collaboration

While Berg’s team focuses on AML, they are far from siloed in their research. “Working at the Centre for Discovery in Cancer Research allows for collaboration with other researchers focused on other types of cancer and allows us to work together with outstanding researchers in the fields of immunology, stem cell biology and metabolism,” says Berg.

“We share our experiences, research technologies, and collaborate on ways to improve outcomes for patients with a variety of cancers. Our work recently, for example, helped to better understand the effect of a novel experimental approach in prostate and lung cancer. We’re very open to collaborating locally, provincially, nationally and internationally.”

 

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Health Canada approves updated Moderna COVID-19 vaccine

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TORONTO – Health Canada has authorized Moderna’s updated COVID-19 vaccine that protects against currently circulating variants of the virus.

The mRNA vaccine, called Spikevax, has been reformulated to target the KP.2 subvariant of Omicron.

It will replace the previous version of the vaccine that was released a year ago, which targeted the XBB.1.5 subvariant of Omicron.

Health Canada recently asked provinces and territories to get rid of their older COVID-19 vaccines to ensure the most current vaccine will be used during this fall’s respiratory virus season.

Health Canada is also reviewing two other updated COVID-19 vaccines but has not yet authorized them.

They are Pfizer’s Comirnaty, which is also an mRNA vaccine, as well as Novavax’s protein-based vaccine.

This report by The Canadian Press was first published Sept. 17, 2024.

Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.

The Canadian Press. All rights reserved.

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These people say they got listeria after drinking recalled plant-based milks

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TORONTO – Sanniah Jabeen holds a sonogram of the unborn baby she lost after contracting listeria last December. Beneath, it says “love at first sight.”

Jabeen says she believes she and her baby were poisoned by a listeria outbreak linked to some plant-based milks and wants answers. An investigation continues into the recall declared July 8 of several Silk and Great Value plant-based beverages.

“I don’t even have the words. I’m still processing that,” Jabeen says of her loss. She was 18 weeks pregnant when she went into preterm labour.

The first infection linked to the recall was traced back to August 2023. One year later on Aug. 12, 2024, the Public Health Agency of Canada said three people had died and 20 were infected.

The number of cases is likely much higher, says Lawrence Goodridge, Canada Research Chair in foodborne pathogen dynamics at the University of Guelph: “For every person known, generally speaking, there’s typically 20 to 25 or maybe 30 people that are unknown.”

The case count has remained unchanged over the last month, but the Public Health Agency of Canada says it won’t declare the outbreak over until early October because of listeria’s 70-day incubation period and the reporting delays that accompany it.

Danone Canada’s head of communications said in an email Wednesday that the company is still investigating the “root cause” of the outbreak, which has been linked to a production line at a Pickering, Ont., packaging facility.

Pregnant people, adults over 60, and those with weakened immune systems are most at risk of becoming sick with severe listeriosis. If the infection spreads to an unborn baby, Health Canada says it can cause miscarriage, stillbirth, premature birth or life-threatening illness in a newborn.

The Canadian Press spoke to 10 people, from the parents of a toddler to an 89-year-old senior, who say they became sick with listeria after drinking from cartons of plant-based milk stamped with the recalled product code. Here’s a look at some of their experiences.

Sanniah Jabeen, 32, Toronto

Jabeen says she regularly drank Silk oat and almond milk in smoothies while pregnant, and began vomiting seven times a day and shivering at night in December 2023. She had “the worst headache of (her) life” when she went to the emergency room on Dec. 15.

“I just wasn’t functioning like a normal human being,” Jabeen says.

Told she was dehydrated, Jabeen was given fluids and a blood test and sent home. Four days later, she returned to hospital.

“They told me that since you’re 18 weeks, there’s nothing you can do to save your baby,” says Jabeen, who moved to Toronto from Pakistan five years ago.

Jabeen later learned she had listeriosis and an autopsy revealed her baby was infected, too.

“It broke my heart to read that report because I was just imagining my baby drinking poisoned amniotic fluid inside of me. The womb is a place where your baby is supposed to be the safest,” Jabeen said.

Jabeen’s case is likely not included in PHAC’s count. Jabeen says she was called by Health Canada and asked what dairy and fresh produce she ate – foods more commonly associated with listeria – but not asked about plant-based beverages.

She’s pregnant again, and is due in several months. At first, she was scared to eat, not knowing what caused the infection during her last pregnancy.

“Ever since I learned about the almond, oat milk situation, I’ve been feeling a bit better knowing that it wasn’t something that I did. It was something else that caused it. It wasn’t my fault,” Jabeen said.

She’s since joined a proposed class action lawsuit launched by LPC Avocates against the manufacturers and sellers of Silk and Great Value plant-based beverages. The lawsuit has not yet been certified by a judge.

Natalie Grant and her seven year-old daughter, Bowmanville, Ont.

Natalie Grant says she was in a hospital waiting room when she saw a television news report about the recall. She wondered if the dark chocolate almond milk her daughter drank daily was contaminated.

She had brought the girl to hospital because she was vomiting every half hour, constantly on the toilet with diarrhea, and had severe pain in her abdomen.

“I’m definitely thinking that this is a pretty solid chance that she’s got listeria at this point because I knew she had all the symptoms,” Grant says of seeing the news report.

Once her daughter could hold fluids, they went home and Grant cross-checked the recalled product code – 7825 – with the one on her carton. They matched.

“I called the emerg and I said I’m pretty confident she’s been exposed,” Grant said. She was told to return to the hospital if her daughter’s symptoms worsened. An hour and a half later, her fever spiked, the vomiting returned, her face flushed and her energy plummeted.

Grant says they were sent to a hospital in Ajax, Ont. and stayed two weeks while her daughter received antibiotics four times a day until she was discharged July 23.

“Knowing that my little one was just so affected and how it affected us as a family alone, there’s a bitterness left behind,” Grant said. She’s also joined the proposed class action.

Thelma Feldman, 89, Toronto

Thelma Feldman says she regularly taught yoga to friends in her condo building before getting sickened by listeria on July 2. Now, she has a walker and her body aches. She has headaches and digestive problems.

“I’m kind of depressed,” she says.

“It’s caused me a lot of physical and emotional pain.”

Much of the early days of her illness are a blur. She knows she boarded an ambulance with profuse diarrhea on July 2 and spent five days at North York General Hospital. Afterwards, she remembers Health Canada officials entering her apartment and removing Silk almond milk from her fridge, and volunteers from a community organization giving her sponge baths.

“At my age, 89, I’m not a kid anymore and healing takes longer,” Feldman says.

“I don’t even feel like being with people. I just sit at home.”

Jasmine Jiles and three-year-old Max, Kahnawake Mohawk Territory, Que.

Jasmine Jiles says her three-year-old son Max came down with flu-like symptoms and cradled his ears in what she interpreted as a sign of pain, like the one pounding in her own head, around early July.

When Jiles heard about the recall soon after, she called Danone Canada, the plant-based milk manufacturer, to find out if their Silk coconut milk was in the contaminated batch. It was, she says.

“My son is very small, he’s very young, so I asked what we do in terms of overall monitoring and she said someone from the company would get in touch within 24 to 48 hours,” Jiles says from a First Nations reserve near Montreal.

“I never got a call back. I never got an email”

At home, her son’s fever broke after three days, but gas pains stuck with him, she says. It took a couple weeks for him to get back to normal.

“In hindsight, I should have taken him (to the hospital) but we just tried to see if we could nurse him at home because wait times are pretty extreme,” Jiles says, “and I don’t have child care at the moment.”

Joseph Desmond, 50, Sydney, N.S.

Joseph Desmond says he suffered a seizure and fell off his sofa on July 9. He went to the emergency room, where they ran an electroencephalogram (EEG) test, and then returned home. Within hours, he had a second seizure and went back to hospital.

His third seizure happened the next morning while walking to the nurse’s station.

In severe cases of listeriosis, bacteria can spread to the central nervous system and cause seizures, according to Health Canada.

“The last two months have really been a nightmare,” says Desmond, who has joined the proposed lawsuit.

When he returned home from the hospital, his daughter took a carton of Silk dark chocolate almond milk out of the fridge and asked if he had heard about the recall. By that point, Desmond says he was on his second two-litre carton after finishing the first in June.

“It was pretty scary. Terrifying. I honestly thought I was going to die.”

Cheryl McCombe, 63, Haliburton, Ont.

The morning after suffering a second episode of vomiting, feverish sweats and diarrhea in the middle of the night in early July, Cheryl McCombe scrolled through the news on her phone and came across the recall.

A few years earlier, McCombe says she started drinking plant-based milks because it seemed like a healthier choice to splash in her morning coffee. On June 30, she bought two cartons of Silk cashew almond milk.

“It was on the (recall) list. I thought, ‘Oh my God, I got listeria,’” McCombe says. She called her doctor’s office and visited an urgent care clinic hoping to get tested and confirm her suspicion, but she says, “I was basically shut down at the door.”

Public Health Ontario does not recommend listeria testing for infected individuals with mild symptoms unless they are at risk of developing severe illness, such as people who are immunocompromised, elderly, pregnant or newborn.

“No wonder they couldn’t connect the dots,” she adds, referencing that it took close to a year for public health officials to find the source of the outbreak.

“I am a woman in my 60s and sometimes these signs are of, you know, when you’re vomiting and things like that, it can be a sign in women of a bigger issue,” McCombe says. She was seeking confirmation that wasn’t the case.

Disappointed, with her stomach still feeling off, she says she decided to boost her gut health with probiotics. After a couple weeks she started to feel like herself.

But since then, McCombe says, “I’m back on Kawartha Dairy cream in my coffee.”

This report by The Canadian Press was first published Sept. 16, 2024.

Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.

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B.C. mayors seek ‘immediate action’ from federal government on mental health crisis

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VANCOUVER – Mayors and other leaders from several British Columbia communities say the provincial and federal governments need to take “immediate action” to tackle mental health and public safety issues that have reached crisis levels.

Vancouver Mayor Ken Sim says it’s become “abundantly clear” that mental health and addiction issues and public safety have caused crises that are “gripping” Vancouver, and he and other politicians, First Nations leaders and law enforcement officials are pleading for federal and provincial help.

In a letter to Prime Minister Justin Trudeau and Premier David Eby, mayors say there are “three critical fronts” that require action including “mandatory care” for people with severe mental health and addiction issues.

The letter says senior governments also need to bring in “meaningful bail reform” for repeat offenders, and the federal government must improve policing at Metro Vancouver ports to stop illicit drugs from coming in and stolen vehicles from being exported.

Sim says the “current system” has failed British Columbians, and the number of people dealing with severe mental health and addiction issues due to lack of proper care has “reached a critical point.”

Vancouver Police Chief Adam Palmer says repeat violent offenders are too often released on bail due to a “revolving door of justice,” and a new approach is needed to deal with mentally ill people who “pose a serious and immediate danger to themselves and others.”

This report by The Canadian Press was first published Sept. 16, 2024

The Canadian Press. All rights reserved.

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