The impact of Agent Orange exposure on presentation and prognosis of patients with chronic lymphocytic leukemia. Leuk Lymphoma 2014 Jan;55(1):63-6
Date
04/12/2013Pubmed ID
23573826Pubmed Central ID
PMC3975330DOI
10.3109/10428194.2013.794267Scopus ID
2-s2.0-84891366353 (requires institutional sign-in at Scopus site) 13 CitationsAbstract
Exposure to Agent Orange (AO) and the contaminating chemical 2,3,7,8-tetrachlorodibenzodioxin (TCDD) has been associated with the development of chronic lymphocytic leukemia (CLL). Of the 195 veterans diagnosed with CLL from 2001 to 2010 in a retrospective cohort from the Minneapolis Veterans Affairs Medical Center, 33 (17%) were exposed to AO. Prognostic factors including Rai stage, lymphocyte doubling time and cytogenetics did not differ between exposed and unexposed patients. Exposed patients were younger at diagnosis (61 vs. 72 years, p < 0.0001) and time to CLL treatment was shorter (9.6 vs. 30.2 months, p = 0.02). Overall survival did not differ between exposed and unexposed patients on Kaplan-Meier analysis, but when adjusted for age, AO exposure had a hazard ratio of death of 1.8 compared to non-exposure (95% confidence interval 0.7-4.5, p = 0.24). The high estimate of the mortality hazard combined with the relatively low numbers in the exposure group suggests that further examination in a larger patient population is warranted.
Author List
Baumann Kreuziger LM, Tarchand G, Morrison VAAuthor
Lisa M. Baumann Kreuziger MD Associate Professor in the Medicine department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
2,4,5-Trichlorophenoxyacetic Acid2,4-Dichlorophenoxyacetic Acid
Adult
Aged
Aged, 80 and over
Agent Orange
Defoliants, Chemical
Environmental Exposure
Female
Follow-Up Studies
Humans
Leukemia, Lymphocytic, Chronic, B-Cell
Male
Middle Aged
Polychlorinated Dibenzodioxins
Prognosis
Retrospective Studies
Veterans
