The cause is unknown, but it is generally accepted that it is not caused by tobacco, ionizing radiation, or industrial chemicals other than possibly diesel. Farming and gardening appear to increase the risk in some studies. The possibility that HCL is caused by a random accident during routine cell division can not be ruled out.
With respect to compensation for veterans exposed to Agent Orange and other pesticides, the US Institute of Medicine announced "sufficient evidence" of an association between exposure to herbicides and later development of chronic B-cell leukemias and lymphomas in general.
The IOM report emphasizes that neither animal nor human studies indicate that exposure to this herbicide is associated with or connected to HCL specifically, or that data supports even claims of biological plausibility.
The IOM committee is instead applying data from chronic lymphocytic leukemia (CLL) and non-Hodgkin lymphoma (NHL) to draw conclusion about HCL, saying that it "sees no reason to exclude HCL or any other chronic hematoproliferative diseases of B-cell origin lacking its own specific epidemiologic evidence".
As a result of the IOM's decision to lump HCL in with other B-cell leukemias and lymphomas, the US Department of Veterans Affairs listed HCL as an illnesses presumed to be a service-related disability.
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