News briefs

Morning sickness may be good news for pregnancy

A new study published online by JAMA Internal Medicine suggests the “morning sickness” symptoms of nausea and vomiting may be associated with reduced risk of pregnancy loss. As many as 80% of pregnant women report nausea or vomiting or both. Researchers from the Eunice Kennedy Shriver National Institute of Child Health and Human Development in the US examined the relationship between nausea and vomiting and pregnancy loss in a secondary analysis of women with one or two prior pregnancy losses enrolled in a clinical trial. The study included 797 women who had urine test-confirmed pregnancies and nausea symptoms that were tracked in pregnancy diaries and questionnaires. Among 797 women, 188 pregnancies (23.6%) ended in loss. At week 2 of gestation, nearly 18% of women (73 of 409) reported nausea without vomiting and 2.7% of women (11 of 409) reported nausea with vomiting. Those proportions grew to 57.3% of women (254 of 443) and 26.6% of women (118 of 443), respectively, by gestational week 8, the study reported. Nausea and nausea with vomiting were associated with a 50–75% reduction in the risk of pregnancy loss in women with one or two prior pregnancy losses, according to the authors. A number of theories have been proposed regarding the potential mechanism of this association. “Our study confirms prior research that nausea and vomiting appear to be more than a sign of still being pregnant and instead may be associated with a lower risk for pregnancy loss,” the authors concluded.

Australian research points to new lymphoma treatment

An international trial led by Peter MacCallum Cancer Centre radiation oncologist, Professor Michael MacManus, has found that patients with early stage low-grade lymphoma live longer without a relapse with immuno-chemotherapy plus radiotherapy treatment rather than radiotherapy alone. The results of the international phase III TROG 99.03 clinical trial were presented last month during a Plenary Session at the 2016 American Society for Radiation Oncology (ASTRO) Annual Meeting in Boston. The primary aim of the trial was to see if, by adding immuno-chemotherapy to the standard treatment of radiotherapy alone, outcomes could be improved for patients with stage I-II low-grade follicular lymphoma. Patients (150 participants from across Australia, New Zealand and Canada) were randomised to one of two arms; radiotherapy alone or radiotherapy followed by six cycles of cyclophosphamide, vincristine, prednisolone (CVP) or in the later part of the trial, rituximab and CVP (R-CVP). “This is a slow-growing lymphoma and in the short term, the prognosis is good,” Professor MacManus said. “Radiotherapy can cure around half of these patients. However, more than half of the patients will eventually relapse after radiotherapy alone, generally outside the area of the body treated with radiotherapy. Although the disease may then respond well to further therapy, most patients will eventually die from lymphoma after their relapses. It is clear from the trial results that radiotherapy plus R-CVP is associated with a much better chance that patients will survive to 10 years without a relapse. It is likely to mean that the cure rate will be much higher. The long natural history of the disease makes it very difficult to perform randomised trials in these patients, because it takes many years to know if their treatment has been effective. Few trials groups can sustain a trial over the more than 15 years that would be required to answer the question. Our trial has run for 16 years. The results of this trial will immediately inform every discussion of treatment strategy for every patient with stage I-II follicular lymphoma in the developed world.”