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Toxin Exposure and Acute Myeloid Leukemia in Veterans

Members of the United States military who served in Vietnam between 1961 and 1971 risked exposure to the weaponized chemical defoliant known as Agent Orange. Among the components of Agent Orange, benzene and tetrachlorodibenzo-p-dioxin (TCDD) are known carcinogens linked to several cancers. They include multiple myeloma, Hodgkin and non-Hodgkin lymphoma, as well as bladder, prostate, and lung cancer. 

 

In this ReCAP, Dr Timothy O'Brien, section chief of hematology at the Louis Stokes Cleveland VA Medical Center, examines the evidence that suggests a link between service-related Agent Orange exposure and acute myeloid leukemia (AML). He discusses preclinical models that show a relationship between benzene and TCDD exposure and the development of AML. 

 

Dr O'Brien also explains the factors that have limited researchers' ability to positively connect Agent Orange and AML. For example, there is a dwindling cohort of affected patients to study because dioxins can lie latent in fat cells for more than a decade, delaying the development of AML. During that time, many veterans will have died from unrelated causes. 

 

More research is needed for veterans to receive service-connected benefits for AML diagnoses. However, as Dr O'Brien notes, the PACT Act provides coverage for veterans who developed AML after exposure to benzene-contaminated water at Camp Lejeune. 

 

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Timothy O'Brien, MD, Associate Professor, Case Western Reserve University School of Medicine; Chief of Hematology, Louis Stokes Cleveland VA Medical Center, Cleveland, Ohio  

Timothy O'Brien, MD, has disclosed no relevant financial relationships. 

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Members of the United States military who served in Vietnam between 1961 and 1971 risked exposure to the weaponized chemical defoliant known as Agent Orange. Among the components of Agent Orange, benzene and tetrachlorodibenzo-p-dioxin (TCDD) are known carcinogens linked to several cancers. They include multiple myeloma, Hodgkin and non-Hodgkin lymphoma, as well as bladder, prostate, and lung cancer. 

 

In this ReCAP, Dr Timothy O'Brien, section chief of hematology at the Louis Stokes Cleveland VA Medical Center, examines the evidence that suggests a link between service-related Agent Orange exposure and acute myeloid leukemia (AML). He discusses preclinical models that show a relationship between benzene and TCDD exposure and the development of AML. 

 

Dr O'Brien also explains the factors that have limited researchers' ability to positively connect Agent Orange and AML. For example, there is a dwindling cohort of affected patients to study because dioxins can lie latent in fat cells for more than a decade, delaying the development of AML. During that time, many veterans will have died from unrelated causes. 

 

More research is needed for veterans to receive service-connected benefits for AML diagnoses. However, as Dr O'Brien notes, the PACT Act provides coverage for veterans who developed AML after exposure to benzene-contaminated water at Camp Lejeune. 

 

--

 

Timothy O'Brien, MD, Associate Professor, Case Western Reserve University School of Medicine; Chief of Hematology, Louis Stokes Cleveland VA Medical Center, Cleveland, Ohio  

Timothy O'Brien, MD, has disclosed no relevant financial relationships. 

Members of the United States military who served in Vietnam between 1961 and 1971 risked exposure to the weaponized chemical defoliant known as Agent Orange. Among the components of Agent Orange, benzene and tetrachlorodibenzo-p-dioxin (TCDD) are known carcinogens linked to several cancers. They include multiple myeloma, Hodgkin and non-Hodgkin lymphoma, as well as bladder, prostate, and lung cancer. 

 

In this ReCAP, Dr Timothy O'Brien, section chief of hematology at the Louis Stokes Cleveland VA Medical Center, examines the evidence that suggests a link between service-related Agent Orange exposure and acute myeloid leukemia (AML). He discusses preclinical models that show a relationship between benzene and TCDD exposure and the development of AML. 

 

Dr O'Brien also explains the factors that have limited researchers' ability to positively connect Agent Orange and AML. For example, there is a dwindling cohort of affected patients to study because dioxins can lie latent in fat cells for more than a decade, delaying the development of AML. During that time, many veterans will have died from unrelated causes. 

 

More research is needed for veterans to receive service-connected benefits for AML diagnoses. However, as Dr O'Brien notes, the PACT Act provides coverage for veterans who developed AML after exposure to benzene-contaminated water at Camp Lejeune. 

 

--

 

Timothy O'Brien, MD, Associate Professor, Case Western Reserve University School of Medicine; Chief of Hematology, Louis Stokes Cleveland VA Medical Center, Cleveland, Ohio  

Timothy O'Brien, MD, has disclosed no relevant financial relationships. 

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