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Agent Orange Exposure Increases Risk of Progression to Multiple Myeloma

Patients with monoclonal gammopathy had a higher likelihood of progressing to multiple myeloma if they had past exposure to Agent Orange, a mixture of herbicides used during the Vietnam War. Researchers published the finding, based on data from 211 patients at the John D. Dingell Veterans Affairs Medical Center in Detroit, online in the journal Clinical Lymphoma, Myeloma & Leukemia. 

“Monoclonal gammopathy is a premalignant condition with the risk of progressing to multiple myeloma. Exposure to Agent Orange has been implicated in multiple conditions including multiple myeloma,” researchers wrote. “Our study demonstrates an increased risk of progression in exposed patients.”

Researchers conducted a retrospective chart review of patients seen at the VA medical center between 2005 and 2015 with monoclonal gammopathy of undetermined significance, smoldering multiple myeloma, and multiple myeloma. Of the 211 patients, 96% were men and 122 were African American. Eleven had reported exposure to Agent Orange. 

In the overall study population, the cumulative risk of progression was 1.4% at 1 year, according to the study. In the population reporting Agent Orange exposure, however, the risk of progressing to multiple myeloma was significantly higher: researchers reported a hazard ratio of 11.19. 

While overall survival in patients exposed to Agent Orange was a median 7 years compared with 11.1 years in patients with no such exposure, multivariable analysis showed no association between Agent Orange exposure and shortened overall survival, according to the study. 

Jolynn Tumolo

Reference

Bumma N, Nagasaka M, Hemingway G, et al. Effect of Exposure to Agent Orange on the Risk of Monoclonal Gammopathy and Subsequent Transformation to Multiple Myeloma: A Single-Center Experience From the Veterans Affairs Hospital, Detroit [published online ahead of print, 2019 Dec 28]. Clin Lymphoma Myeloma Leuk. 2019;S2152-2650(19)32163-9. doi:10.1016/j.clml.2019.11.014

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