Agent Orange and Hematologic Malignancies: The Fog of War Still Hovers

More than 40 years after the Vietnam War, the fog of Agent Orange hangs thick over veterans and those providing their medical care. Aging veterans suffer from an extensive list of diseases, including several hematologic malignancies, deemed related, or possibly related, to exposure to Agent Orange.

Many cases we see may resonate back to historic events that we don’t pay much attention to, in part because it is difficult to dissect the details.”
—C. Ola Landgren, MD, PhD

The number of affected veterans will likely increase as new conditions are added to the official list of “presumptive diseases” and as controversies are resolved regarding which veterans were affected (and how the U.S. government should compensate and care for them). Although the science connecting Agent Orange exposure and certain hematologic malignancies is sound, the story of Agent Orange is far from clear-cut. It is covered with a sticky mist of politics, controversy, blame, and denial.

“Many cases we see in our clinics may resonate back to historic events that we don’t pay much attention to, in part because it is difficult to dissect the details,” said C. Ola Landgren, MD, PhD, chief of the myeloma service at Memorial Sloan Kettering Cancer Center in New York, who has extensively studied the link between environmental exposures and multiple myeloma (MM).

To help unravel the story, ASH Clinical News spoke with Dr. Landgren and ASH Clinical News Associate Editor David Steensma, MD, about the science behind Agent Orange, the clinical considerations of exposure, and the task of caring for ill veterans.

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