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Agent Orange and Multiple Myeloma



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Agent Orange and Multiple Myeloma

Agent Orange Brief

D8

Prepared by the Environmental Agents Service (131)

VA Central Office, Washington, DC 20420

October 2003



Agent Orange and Multiple Myeloma


What is multiple myeloma?

Multiple myeloma is cancer of specific bone marrow cells, the plasma cell, characterized by plasma cell tumors in various bones of the body.


Why are Vietnam veterans concerned about multiple myeloma? Is it caused by Agent Orange?

Some Vietnam veterans have been diagnosed with multiple myeloma and others have expressed concern about developing this cancer. Some research has suggested that multiple myeloma may be associated with exposure to herbicides, but there is no conclusive scientific evidence that Agent Orange or other herbicides cause this condition.


What did the National Academy of Sciences (NAS) conclude about multiple myeloma in its 1993 report, entitled Veterans and Agent Orange - Health Effects of Herbicides Used in Vietnam?

The NAS reviewers found "limited/suggestive evidence" of an association between herbicide exposure and the subsequent development of multiple myeloma.


What was VA's reaction to this NAS finding?

VA found the evidence concerning multiple myeloma convincing. Most of the studies reviewed by the NAS showed an increased risk, although in most cases it was not a statistically significant increase. Multiple myeloma is closely related biologically to B-cell non-Hodgkin's lymphoma; consequently, the epidemiological evidence concerning non-Hodgkin's lymphoma gives added weight to the association between herbicide exposure and multiple myeloma.

Based on this clinical consideration and the weight of the epidemiological evidence, Secretary Brown concluded that there is a positive association between herbicide exposure and multiple myeloma that manifests itself to a degree of ten percent at any time after exposure.

The proposed rule regarding multiple myeloma was published for public comment in the Federal Register in February 1994. (See 59 Fed. Reg. 5161, February 3, 1994). The final rule was published in the Federal Register in June 1994. (See 59 Fed. Reg. 29723, June 9, 1994).


What did Public Law 103-446 do for Vietnam veterans with multiple myeloma?

Section 505, Public Law 103-446, the Veterans' Benefits Improvements Act of 1994, enacted November 2, 1994, codified (established in law) presumptions of service connection for certain diseases -- including multiple myeloma manifested to a degree of disability of 10 percent or more -- associated with exposure to certain herbicide agents.


What did the NAS 1996 update conclude about multiple myeloma?

New data analyzed for 1996 did not change the NAS view that there is a "limited/suggestive association between exposure to herbicides and multiple myeloma."


Where can a veteran get additional information on this subject?

The following Agent Orange Brief fact sheets (including the one you are reading) are available on the World Wide Web at www.va.gov/AgentOrange: A1.Agent Orange - General Information; A2.Agent Orange Class Action Lawsuit; B1.Agent Orange Registry Program; B2.Agent Orange - Health Care Eligibility; B3.Agent Orange and VA Disability Compensation; B4.VA Information Resources on Agent Orange and Related Matters; C1.Agent Orange - The Problem Encountered in Research; C2.Agent Orange and Vietnam Related Research - VA Projects; C3.Agent Orange and Vietnam Related Research - Non-VA Projects; D1.Agent Orange and Birth Defects; D2.Agent Orange and Chloracne; D3.Agent Orange and Non-Hodgkin's Lymphoma; D4.Agent Orange and Soft Tissue Sarcomas; D5.Agent Orange and Peripheral Neuropathy; D6.Agent Orange and Hodgkin's Disease; D7.Agent Orange and Porphyria Cutanea Tarda; D8.Agent Orange and Multiple Myeloma; D9.Agent Orange and Respiratory Cancers; D10.Agent Orange and Prostate Cancer; D11.Agent Orange and Spina Bifida; D12.Agent Orange and Diabetes; and D13.Agent Orange and Chronic Lymphocytic Leukemia. Hard copies can be obtained from local VA medical centers or from the VA Central Office at the Environmental Agents Service (131) Department of Veterans Affairs, 810 Vermont Avenue, N.W., Washington, DC 20420.

At the same Web site you will find copies of past and current issues of the "Agent Orange Review" newsletter and other items of interest.

This fact sheet was updated in August 2005 and does not include any subsequent developments.





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