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A recent review of three scientific studies indicates that there is “limited/suggestive evidence” of an association between exposure to herbicides in Vietnam and the development of acute myelogenous leukemia (AML) in the children of veterans, according to a recent report from the U.S. Institute of Medicine (IOM).

Acute myelogenous leukemia is a cancer of the bone marrow and blood that is characterized by the rapid, uncontrolled, abnormal growth of immature white blood cells known as myelocytes. These leukemia cells crowd the bone marrow, suppressing formation and function of other blood cells, and ultimately invade other parts of the body including the blood, lymph system, and vital organs. AML accounts for 8% of all childhood cancers.

Veterans and Agent Orange: Update 2000 is the fourth in a series of five congressionally mandated studies designed to evaluate evidence linking exposure to herbicides, such as Agent Orange, that were used in Vietnam with various adverse health conditions. The report was based on three studies that investigated the results of exposure to Agent Orange. Two of these studies were conducted in the U.S. and Australia and both specifically examined the risk of AML in the children of Vietnam veterans. Both studies indicated an association between Agent Orange and AML, but not other forms of leukemia. Furthermore, the results of the Australian study indicate that AML is three to six times more prevalent in the children of veterans than in other children. In addition, both the U.S. study and the Australian study indicated a strong association in children who were diagnosed with AML at a very young age. The development of a disease at such a young age often indicates that the cause of the disease originates from the parent.

The third study was conducted by the U.S. Children’s Cancer Study Group and indicated a 2.7-fold increased risk of AML in the children of fathers with self-reported exposure to pesticides or weed killers of more than 1,000 days. The results of this study, combined with the other two studies, provided enough evidence of an association between herbicide exposure and AML to warrant placing AML under the category of “limited/suggestive evidence of an association” in the Update 2000. Previously, in Update 1998, AML had been placed under the category of “inadequate/insufficient evidence to determine whether an association exists.”

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The IOM will release the final report on Agent Orange and adverse health effects in 2002. In the meantime, more studies are underway to further define the role of Agent Orange and other herbicides in the development of AML. (Veterans and Agent Orange: Update 2000, U.S. Institute of Medicine)

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