Survival in Agent Orange exposed and unexposed Vietnam era Veterans who were diagnosed with lymphoid malignancies

Abstract: Agent Orange (AO) was an herbicide mixture that was contaminated with the carcinogenic 2,3,7,8-tetrachlorodibenzo-p-dioxin. . Between 1962 and 1971, AO was widely sprayed throughout Vietnam and the demilitarized zone in Korea to destroy vegetation that hid or fed enemy forces during Operation Ranch Hand. Here we evaluate outcomes among Vietnam veterans who were diagnosed with lymphoid malignancies using data from the VA Central Cancer Registry. The study compared survival between AO-exposed and AO-unexposed veterans who served between 1/9/1962 and 5/7/74 and were diagnosed with lymphoid malignancies between 10/1/1998 and 12/31/2020. Patient and disease characteristics were summarized using descriptive statistics. The Chi-Square test and Wilcoxon rank sum tests were used to compare the association between categorical and continuous variables, respectively. In our study, AO-exposed veterans with DLBCL, HL, MCL, MZL, and NOS had longer median OS compared to those who were unexposed. AO-exposed patients with MCL, but not the other subtypes, had a higher median number of clinic visits 2 years prior to diagnosis. Our findings indicate that history of remote AO exposure does not define a distinct risk stratum for Vietnam era veterans with lymphoid malignancies. They also illustrate the need for prospective data collection beginning immediately after service.

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