What is multiple myeloma?

Multiple myeloma is cancer of specific bone marrow cells, the plasma cell, characterized by plasma cell tumors in various bones of the body.

Why are Vietnam veterans concerned about multiple myeloma? Is it caused by Agent Orange?

Some Vietnam veterans have been diagnosed with multiple myeloma and others have expressed concern about developing this cancer. Some research has suggested that multiple myeloma may be associated with exposure to herbicides, but there is no conclusive scientific evidence that Agent Orange or other herbicides cause this condition.

What did the National Academy of Sciences (NAS) conclude about multiple myeloma in its 1993 report, entitled Veterans and Agent Orange - Health Effects of Herbicides Used in Vietnam?

The NAS reviewers found "limited/suggestive evidence" of an association between herbicide exposure and the subsequent development of multiple myeloma.

What was VA's reaction to this NAS finding?

VA found the evidence concerning multiple myeloma convincing. Most of the studies reviewed by the NAS showed an increased risk, although in most cases it was not a statistically significant increase. Multiple myeloma is closely related biologically to B-cell non-Hodgkin's lymphoma; consequently, the epidemiological evidence concerning non-Hodgkin's lymphoma gives added weight to the association between herbicide exposure and multiple myeloma.

Based on this clinical consideration and the weight of the epidemiological evidence, Secretary Brown concluded that there is a positive association between herbicide exposure and multiple myeloma that manifests itself to a degree of ten percent at any time after exposure.

The proposed rule regarding multiple myeloma was published for public comment in the Federal Register in February 1994. (See 59 Fed. Reg. 5161, February 3, 1994). The final rule was published in the Federal Register in June 1994. (See 59 Fed. Reg. 29723, June 9, 1994).

What did Public Law 103-446 do for Vietnam veterans with multiple myeloma?

Section 505, Public Law 103-446, the Veterans' Benefits Improvements Act of 1994, enacted November 2, 1994, codified (established in law) presumptions of service connection for certain diseases -- including multiple myeloma manifested to a degree of disability of 10 percent or more -- associated with exposure to certain herbicide agents.

What did the NAS 1996 update conclude about multiple myeloma?

New data analyzed for 1996 did not change the NAS view that there is a "limited/suggestive association between exposure to herbicides and multiple myeloma."

Where can a veteran get additional information on this subject?

Information on multiple myeloma and related matters can be obtained at VA medical center libraries from the Registry Physicians at every VA medical center, or from the Environmental Agents Service (131), Department of Veterans Affairs, 810 Vermont Avenue, N.W., Washington, DC 20420.