The impact of Agent Orange exposure on presentation and prognosis of patients with chronic lymphocytic leukemia

Kreuziger, Lisa Baumann; Tarchand, Gobind; Morrison, Vicki A.

doi:10.3109/10428194.2013.794267

Cited by 13 publications

(6 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although found in young patients, LCL is not rare in 30 to 40-year-old patients [30]. The clinical incidence is not very different from our descriptions above, with less than sick individuals who have suffered from attacks, scarce incidence of hemolytic state and initial infection.…”

Section: Discussioncontrasting

confidence: 53%

Long-term Outcomes in Patients with Chronic Lymphocytic Leukemia Treated with Standard Therapy

Martha¹,

Veronica²,

Maricela³

et al. 2018

J Leuk

View full text Add to dashboard Cite

The purpose of this study was to report the therapeutic results obtained from prospective protocols at the Hematology Service of our hospital, over the course of this century, before new drugs were used. All patients underwent chemotherapy (only one recent group also received rituximab).All LCL patients taken care of at the Hematology Service of the National Medical Center (CMN) "20 de Noviembre", ISSSTE. Patients included in this study were diagnosed with LCL and met the following criteria: persistent lymphocytosis above 5 × 109/L, for more than three months; typical lymphocytic morphology, with less than 10% of immature forms; immunophenotype of B strain with CD5, CD19, CD 79a, CD 20, CD22, CD23, CD24, CD25 + low-intensity SmIg; 30%+ lymph cells in the bone marrow.

show abstract

Section: Discussioncontrasting

confidence: 53%

Long-term Outcomes in Patients with Chronic Lymphocytic Leukemia Treated with Standard Therapy

Martha¹,

Veronica²,

Maricela³

et al. 2018

J Leuk

View full text Add to dashboard Cite

show abstract

“…The US Department of Veterans Affairs has accepted that exposure to Agent Orange is a risk factor for CLL, which has enabled veterans with CLL to claim benefits if they were previously exposed to Agent Orange while in military service 33 . In addition, evidence suggests that exposure to insecticides might be a risk factor for CLL 34 .…”

Section: Epidemiologymentioning

confidence: 99%

Chronic lymphocytic leukaemia

Kipps

Stevenson

et al. 2017

Nat Rev Dis Primers

413

437

View full text Add to dashboard Cite

Chronic lymphocytic leukaemia (CLL) is a malignancy of CD5+ B cells that is characterized by the accumulation of small, mature-appearing lymphocytes in the blood, marrow and lymphoid tissues. Signalling via surface immunoglobulin, which constitutes the major part of the B cell receptor, and several genetic alterations play a part in CLL pathogenesis, in addition to interactions between CLL cells and other cell types, such as stromal cells, T cells and nurse-like cells in the lymph nodes. The clinical progression of CLL is heterogeneous and ranges from patients who require treatment soon after diagnosis to others who do not require therapy for many years, if at all. Several factors, including the immunoglobulin heavy-chain variable region gene (IGHV) mutational status, genomic changes, patient age and the presence of comorbidities, should be considered when defining the optimal management strategies, which include chemotherapy, chemoimmunotherapy and/or drugs targeting B cell receptor signalling or inhibitors of apoptosis, such as BCL-2. Research on the biology of CLL has profoundly enhanced our ability to identify patients who are at higher risk for disease progression and our capacity to treat patients with drugs that selectively target distinctive phenotypic or physiological features of CLL. How these and other advances have shaped our current understanding and treatment of patients with CLL is the subject of this Primer.

show abstract

“…The median age at CLL diagnosis in our study was 57 years compared to the median age at diagnosis in the US of 72 years . A recent study of 195 adult veterans who were exposed to Agent Orange and developed CLL showed no differences between the exposed and non‐exposed for Rai staging, lymphocyte doubling time, cytogenetic changes or survival . However, the Agent Orange exposed veterans were both significantly younger at time of diagnosis and the latent period was significantly shorter than it was for the non‐exposed veterans.…”

Section: Discussionmentioning

confidence: 97%

“…We were particularly interested in examining the effects of radiation exposures and the age at time of first exposure on the latent period on the basis of two previous reports of apparent alterations in the clinical course of leukemia because of induction by radiation or a chemical . An early report concerning children with acute leukemia from the study of A‐bomb survivors in Hiroshima and Nagasaki indicated that younger age at time of exposure was associated with a shorter latent period prior to the appearance of clinical disease .…”

Section: Discussionmentioning

confidence: 99%

Clinical characteristics of chronic lymphocytic leukemia occurring in chornobyl cleanup workers

Finch

Dyagil

Reiss

et al. 2016

Hematological Oncology

View full text Add to dashboard Cite

The recently demonstrated radiation-induction of chronic lymphocytic leukemia (CLL) raises the question as to whether the amount of radiation exposure influences any of the clinical characteristics of the disease. We evaluated the relationship between bone marrow radiation doses and clinical characteristics and survival of 79 CLL cases diagnosed during 1986–2006 in a cohort of 110,645 male workers who participated in the cleanup work of the Chornobyl nuclear accident in Ukraine in 1986. All diagnoses were confirmed by an independent International Hematology Panel. Patients were followed up to the date of death or end of follow-up on October 31, 2010. The median age at diagnosis was 57 years. Median bone marrow dose was 22.6 milligray (mGy) and was not associated with time between exposure and clinical diagnosis of CLL (latent period), age, peripheral blood lymphocyte count or clinical stage of disease in univariate and multivariate analyses. A significant increase in the risk of death with increasing radiation dose was observed (P=0.03, hazard ratio=2.38, 95% confidence interval: 1.11,5.08 comparing those with doses ≥22 mGy to doses <22 mGy). After adjustment for radiation dose, survival of CLL cases was significantly shorter among those with younger age at first exposure, higher peripheral blood lymphocyte count, more advanced clinical stage of disease and older age at diagnosis (all P<0.05). This is the first study to examine association between bone marrow radiation doses from the Chornobyl accident and clinical manifestations of the CLL in Chornobyl cleanup workers. The current study provides new evidence on the association of radiation dose and younger age at first radiation exposure at Chornobyl with shorter survival after diagnosis. Future studies are necessary with more cases in order to improve the statistical power of these analyses and to determine their significance.

show abstract

The impact of Agent Orange exposure on presentation and prognosis of patients with chronic lymphocytic leukemia

Cited by 13 publications

References 6 publications

Long-term Outcomes in Patients with Chronic Lymphocytic Leukemia Treated with Standard Therapy

Long-term Outcomes in Patients with Chronic Lymphocytic Leukemia Treated with Standard Therapy

Chronic lymphocytic leukaemia

Clinical characteristics of chronic lymphocytic leukemia occurring in chornobyl cleanup workers

Contact Info

Product

Resources

About