MINNEAPOLIS—Exposure to Agent Orange was not associated with either poor prognostic factors or shortened overall survival in a large veteran population with chronic lymphocytic leukemia (CLL), even though it is associated with development of the disease, according to a study in the journal Leukemia & Lymphoma.1
Researchers from the Minneapolis VAMC and colleagues performed a retrospective study of 2,052 Vietnam veterans identified in the National VA Tumor Registry to assess the impact of Agent Orange exposure on CLL prognosis, treatment and survival.
Results indicated that prognostic factors did not differ based on exposure. The study found that veterans exposed to Agent Orange were diagnosed younger—63.2 vs. 70.5 years—and had longer overall survival (median not reached vs. 91 months).
Study authors noted that the prolonged survival was in the subgroups of patients aged 60-69 years and those with 11q deletion.
“In addition, those exposed to AO were more likely to be treated with fludarabine, chlorambucil and rituximab (38 vs. 21%, p < .001) and bendamustine plus rituximab (25 vs. 18%, p = 0.039) as first-line therapy,” the researchers wrote.
Mescher C, Gilbertson D, Randall NM, Tarchand et. al. The impact of Agent Orange exposure on prognosis and management in patients with chronic lymphocytic leukemia: a National Veteran Affairs Tumor Registry Study. Leuk Lymphoma. 2017 Sep 14:1-8. doi: 10.1080/10428194.2017.1375109. [Epub ahead of print] PubMed PMID: 28905668.
Guidelines frequently aren’t followed when it comes to radical cholecystectomy with regional lymphadenectomy for patients with T1b gallbladder cancer.
Unlike in most private sector settings, veterans with advanced cancer can receive hospice care concurrently with treatments such as radiation and chemotherapy.