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.
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.
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.”
The Canadian government says it will donate up to 200,000 vaccine doses to fight the mpox outbreak in Congo and other African countries.
It says the donated doses of Imvamune will come from Canada’s existing supply and will not affect the country’s preparedness for mpox cases in this country.
Minister of Health Mark Holland says the donation “will help to protect those in the most affected regions of Africa and will help prevent further spread of the virus.”
Dr. Madhukar Pai, Canada research chair in epidemiology and global health, says although the donation is welcome, it is a very small portion of the estimated 10 million vaccine doses needed to control the outbreak.
Vaccine donations from wealthier countries have only recently started arriving in Africa, almost a month after the World Health Organization declared the mpox outbreak a public health emergency of international concern.
A few days after the declaration in August, Global Affairs Canada announced a contribution of $1 million for mpox surveillance, diagnostic tools, research and community awareness in Africa.
On Thursday, the Africa Centres for Disease Control and Prevention said mpox is still on the rise and that testing rates are “insufficient” across the continent.
Jason Kindrachuk, Canada research chair in emerging viruses at the University of Manitoba, said donating vaccines, in addition to supporting surveillance and diagnostic tests, is “massively important.”
But Kindrachuk, who has worked on the ground in Congo during the epidemic, also said that the international response to the mpox outbreak is “better late than never (but) better never late.”
“It would have been fantastic for us globally to not be in this position by having provided doses a much, much longer time prior than when we are,” he said, noting that the outbreak of clade I mpox in Congo started in early 2023.
Clade II mpox, endemic in regions of West Africa, came to the world’s attention even earlier — in 2022 — as that strain of virus spread to other countries, including Canada.
Two doses are recommended for mpox vaccination, so the donation may only benefit 100,000 people, Pai said.
Pai questioned whether Canada is contributing enough, as the federal government hasn’t said what percentage of its mpox vaccine stockpile it is donating.
“Small donations are simply not going to help end this crisis. We need to show greater solidarity and support,” he said in an email.
“That is the biggest lesson from the COVID-19 pandemic — our collective safety is tied with that of other nations.”
This report by The Canadian Press was first published Sept. 13, 2024.
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.
The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.
Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.
“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”
The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.
A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.
Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.
“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.
Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.
The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.
“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.
This report by The Canadian Press was first published Sept. 11, 2024.
ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.
Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.
Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.
Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.
The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.
“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.
Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.
Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.
Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.
A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.
This report by The Canadian Press was first published Sept. 10, 2024.
