Agent Orange and Serious Diseases including Multiple Myeloma

Nicolas J. Jury, PhD, Diana Zuckerman, PhD, National Center for Health Research

Agent_Orange_CropdustingIt has taken many years to determine how Agent Orange exposure during the Vietnam War has harmed the health of those who were exposed. One of the reasons is that it can take decades for cancer to develop after a dangerous exposure.  Agent Orange was used extensively by the United States military during the Vietnam War to clear vegetation to make it easier to see enemy soldiers. Agent Orange was contaminated with dioxin, making it more dangerous to humans. Nearly 1.5 million veterans were exposed to Agent Orange during the war[1]  when approximately, 20 million gallons of Agent Orange were sprayed over Vietnam during Operation Ranch Hand.[2,3]

Although more research is still needed to learn more about the risks of Agent Orange, by 2012, the Institute of Medicine had concluded that individuals exposed to Agent Orange are more likely to develop these types of cancers and serious diseases:[4]

Cancers

  • Chronic B-cell leukemia
  • Chronic lymphocytic leukemia
  • Hodgkin disease
  • Non-Hodgkin lymphoma
  • Prostate cancer
  • Respiratory cancers (bronchus, larynx, lung, and trachea)
  • Soft tissue sarcoma

Serious Diseases

  • Early-onset peripheral neuropathy
  • High blood pressure
  • Ischemic heart disease
  • Parkinson disease
  • Stroke
  • Type 2 diabetes

The report also stated that some of the children being born to those exposed had spinal cord birth defects.[4]

New research indicates Agent Orange also increases the chances of developing a type of cancer of the bone marrow called multiple myeloma.

Veterans who have been exposed to Agent Orange or other herbicides during military service are eligible to receive Veterans Administration health care benefits and compensation for respiratory cancers without having to prove the connection between their disease and exposure.[5]

Does Agent Orange cause Multiple Myeloma?

Bone marrow is crucial for making new blood cells. Multiple myeloma causes blood cells to accumulate in the bone marrow and interfere with the process of making new blood cells.[6]  Patients who develop multiple myeloma are usually diagnosed first with a condition called monoclonal gammopathy of undetermined significance (MGUS).[7,8]  Patients who have MGUS tend to develop multiple myeloma, and this risk increases over time.[9]  More than 26,000 people are expected to be diagnosed with multiple myeloma this year, and less than half are predicted to survive.[10]

In its 2012 report, the Institute of Medicine stated that there was insufficient evidence to conclude that exposure to Agent Orange can cause multiple myeloma.[4]  In its 2012 report, the Institute of Medicine stated that there was insufficient evidence to conclude that exposure to Agent Orange can cause multiple myeloma.[4]  However, in 2016 the VA determined that Agent Orange and other herbicides are assumed to be connected to multiple myeloma, making veterans eligible for VA health care and disability compensation.[11] This decision was supported by a study published in a cancer journal in 2015 indicating that veterans who were exposed to Agent Orange were 2.4 times more likely to develop MGUS than the veterans who were not exposed to it.[12]  The study was based on 958 veterans who served in the United States Air Force during Operation Ranch Hand.

All articles are reviewed and approved by Dr. Diana Zuckerman and other senior staff. 

  1. Agent Orange and Cancer (Internet). 2014 (cited 2015 Sep 28). Available from: http://www.cancer.org/cancer/cancercauses/othercarcinogens/intheworkplace/agent-orange-and-cancer
  2. Fleischer DZ, Zames F. The disability rights movement: from charity to confrontation. 178 p.
  3. Lewis JG. James G. Lewis on Smokey Bear in Vietnam. Environ Hist. 2006 Jul;11(3):598–603.
  4. Committee to Review the Health Effects in Vietnam Veterans of Exposure to Herbicides (Ninth Biennial Update), Board on the Health of Select Populations, Institute of Medicine. Veterans and Agent Orange: Update 2012 (Internet). Washington (DC): National Academies Press (US); 2014 (cited 2015 Sep 28). Available from: http://www.ncbi.nlm.nih.gov/books/NBK195090/
  5. Respiratory Cancers and Agent Orange – Public Health (Internet). (cited 2015 Oct 12). Available from: http://www.publichealth.va.gov/exposures/agentorange/conditions/respiratory_cancers.asp
  6. Raab MS, Podar K, Breitkreutz I, Richardson PG, Anderson KC. Multiple myeloma. Lancet Lond Engl. 2009 Jul 25;374(9686):324–39.
  7. Bladé J. Clinical practice. Monoclonal gammopathy of undetermined significance. N Engl J Med. 2006 Dec 28;355(26):2765–70.
  8. Landgren O, Kyle RA, Pfeiffer RM, Katzmann JA, Caporaso NE, Hayes RB, et al. Monoclonal gammopathy of undetermined significance (MGUS) consistently precedes multiple myeloma: a prospective study. Blood. 2009 May 28;113(22):5412–7
  9. International Myeloma Working Group. Criteria for the classification of monoclonal gammopathies, multiple myeloma and related disorders: a report of the International Myeloma Working Group. Br J Haematol. 2003 Jun;121(5):749–57.
  10. Myeloma – SEER Stat Fact Sheets (Internet). (cited 2015 Sep 29). Available from: http://seer.cancer.gov/statfacts/html/mulmy.html
  11. U.S. Department of Veterans Affairs. (2016). Multiple Myeloma and Agent Orange. Available from: https://www.publichealth.va.gov/exposures/agentorange/conditions/multiple_myeloma.asp.
  12. Landgren O, Shim YK, Michalek J, Costello R, Burton D, Ketchum N, et al. Agent Orange Exposure and Monoclonal Gammopathy of Undetermined Significance: An Operation Ranch Hand Veteran Cohort Study. JAMA Oncol. 2015 Sep 3;