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LEUKEMIA LYMPHOMA MYELOMA
Table of Contents
1 2 E x e cu t i ve S u m m ar y A b o ut t h e D i s e a s e s
2 3 3 Treatment Follow-up Care New Approaches to Treatment Living with Leukemia New Cases Incidence by Gender Incidence by Race and Ethnicity Incidence by Age-Group Signs and Symptoms of Leukemia Possible Causes of Leukemia Treatment of Leukemia Survival Deaths Hodgkin Lymphoma Non-Hodgkin Lymphoma Living with Lymphoma New Cases Incidence by Gender Incidence by Race and Ethnicity Incidence in Children Incidence in Adults Signs and Symptoms Treatment Survival for Adults Survival for Children Deaths Living with Myeloma New Cases Signs and Symptoms Possible Causes Treatment Survival Deaths
Fi gur es
1 2 7 8 8 9
Figure 1: Five-Year Relative Survival Rates, 1960-1963 vs. 1975-1977 vs. 1996-2003 Figure 2: Estimated New Cases (%) of Blood Cancers in 2007 Figure 3: Estimated Proportion of New Cases (%) in 2007 for Each Type of Leukemia Including Adults and Children Figure 4: Age-Specific Incidence Rates for Acute Myelogenous Leukemia (All Races), 2000-2004 Figure 5: Five-Year Relative Survival Rates for All Ages, All Types of Leukemia, 1975-2003 Figure 6: Five-Year Relative Survival Rates for Acute Lymphocytic Leukemia, in Children Under 15 Years of Age, 1964-2003
6 6 6 7 7 7 7 8 8 9 10 10 10 10 10 10 11 11 11 11 11 11 11 13 13 13 13 13 13 13
12 Figure 7: Age-Specific Incidence Rates for Hodgkin Lymphoma, 2000-2004 12 Figure 8: Age-Specific Incidence Rates for Non-Hodgkin Lymphoma, 2000-2004 13 Figure 9: Age-Specific Incidence Rates for Myeloma, 2000-2004
6 6 9
Table 1: The Four Major Types of Leukemia Table 2: Approximate U.S. Prevalence of the Four Major Leukemias as of Jan. 1, 2004 Table 3: Total Estimated Number of New Leukemia Cases in the United States for 2007 Table 4: Estimated Deaths (All Age-Groups) from All Types of Leukemia in 2007
10 Table 5: New Cases of Lymphoma by Gender, 2007 12 Table 6: Trends in Five-Year Relative Survival Rates by Race for Hodgkin Lymphoma and Non-Hodgkin Lymphoma 12 Table 7: Estimated Deaths by Gender from Hodgkin Lymphoma and Non-Hodgkin Lymphoma 14 Table 8: Incidence Rates by Gender, All Races, per 100,000 Population (2000-2004) 14 Table 9: Incidence Rates by Gender, for Blacks, per 100,000 Population (2000-2004) 14 Table 10: Incidence Rates by Gender, for Whites, per 100,000 Population (2000-2004) 15 Table 11: Estimated New Cases of Blood Cancers by Site, by State, 2007 15 Table 12: Estimated Deaths from Blood Cancers by Site, by State, 2007
14 Incidence Rates: Leukemia, Lymphoma a nd My eloma 16 Notes and Definitions 17 Citations 18 About the Society
18 Research 19 Patient Services 20 Advocacy
Cover Photo: Light microscopy (Magnification = 700x) of a human lymphoma cell. Credit: Dr. Cecil H. Fox/Photo Researchers, Inc.
• Every five minutes. 1998.266 people living today with lymphoma. • Thirty-two percent more males are living with leukemia than females. • Eighty-six percent of myeloma cases occur in people aged 55 and over. Myeloma: • • • • There are 60. the likelihood of dying from most leukemias*. lymphoma and myeloma are cancers that originate in the bone marrow or lymphatic tissues as the result of an acquired genetic injury to the DNA of a single cell. Hodgkin and non-Hodgkin lymphoma and myeloma will account for nearly 9.349 Americans are living with leukemia. 2007 and SEER 19731993.4 percent of the 1. 44. and its age-adjusted incidence rose by nearly 84 percent from 1975 to 2004. 1996.520 people in the United States will be diagnosed with leukemia. www. This abnormal accumulation interferes with the production of healthy blood cells. The next SEER Cancer Statistics Review is expected to be published online in April 2008. • New cases of leukemia.444. These data were published online by SEER. 71. National Cancer Institute. • Leukemia causes more deaths than any other cancer among children and young adults under the age of 20. *Myeloma Biology and Management. is a compilation of the most recent data on leukemia. • In general.Executive Summary Facts 2007-2008. Oxford University Press. the National Cancer Institute’s Surveillance.190 cases of non-Hodgkin). lymphoma and myeloma will cause the deaths of an estimated 52. This statistic represents 143 people each day. lymphoma and myeloma. National Cancer Institute. Highlights from the Report Include: New Cases • An estimated 135.650 total cancer-related deaths. • Non-Hodgkin lymphoma is the fifth most common cancer in the United States. • Every 10 minutes.920 new cancer cases diagnosed in the United States this year. or nearly six people every hour. Survival • An estimated 823. 2nd Edition. Deaths • Leukemia. 21.190 cases of Hodgkin. Leukemia. LEUKEMIA LYMPHOMA MYELOMA page 1 . This year. Five-Year Relative Survival Rates 1960-1963 vs. *except acute myelogenous leukemia (AML) and other. 405. Mortality from the disease increased 24 percent. in April 2007. Epidemiology and End Results Program.gov.900 people will be diagnosed with myeloma.659 people in the United States who are either living with or are in remission from leukemia.313 either have or are in remission from Hodgkin lymphoma.790 people will die of leukemia. lymphoma and myeloma in 2007.660 from non-Hodgkin).cancer. someone dies from a blood cancer. 63. Epidemiology and End Results) Cancer Statistics Review. The data within Facts 2007-2008 reflect the most recent statistics available from SEER.1975-1977 vs. • In 2007. the incidence of myeloma increased 8 percent. which becomes malignant and multiplies continuously. • This year. 138. 1975-2004.424 people living today with myeloma. 1960-1963 1975-1977 1996-2003 Figure 1: Sources: SEER (Surveillance. lymphoma and myeloma decreased from 1995 to 2004 (the last year data were available). nonacute myelogenous and monocytic leukemias Lymphoma: • There are 544. page 16). From 1975 to 2004. someone is diagnosed with a blood cancer. 10. • In 2007.790 people will die from myeloma. Hodgkin and non-Hodgkin lymphoma. 19.380 new cases of lymphoma will be diagnosed in the United States (8. 1996-2003 100% 90% 80% 70% Survival Rates 60% 50% 40% 30% 20% 10% 0% Myeloma Hodgkin Lymphoma Non-Hodgkin Lymphoma Leukemia 34% 26% 12%* 14% 48% 40% 31% 74% 64% 50% 35% 86% Leukemia: • There are 218. • This year.070 from Hodgkin.730 people will die from lymphoma (1.seer. 18. More males are diagnosed with leukemia and more males die of it than females. an annual publication.240 people will be diagnosed with leukemia. Cancer Statistics Review 1975-2004 (see Notes.310 people in the United States this year. and myeloma. 19. This year. • These blood cancers will account for 9.3 percent of the deaths from cancer in 2007 based on the 559.953 either have or are in remission from non-Hodgkin lymphoma (NHL).
Stem cells also circulate in large numbers in fetal blood and can be recovered from umbilical cord and placental blood after childbirth. usually a brother or sister with the same tissue type. They are considered to be related cancers because they arise from cells with a common origin (the lymphohematopoietic stem cells) and with related functions. The stem cells are frozen and later they can be thawed and infused into the patient if intensive chemotherapy and/or radiotherapy is required for subsequent treatment. Research is being conducted to improve socalled “haploidentical” transplant. usually in combinations of two or more drugs. 2007. decreased ability to fight infections and a predisposition to bleeding. Blood and Marrow Stem Cell Transplantation: Stem cell transplantation from marrow was introduced approximately 45 years ago and is now standard therapy for selected patients with leukemia. These diseases usually result from an acquired genetic injury to the DNA of a single cell. The blood or marrow stem cells are collected while the patient is in remission. 2007. Syngeneic transplant describes the use of an identical twin as donor. American Cancer Society. An allogeneic transplant uses blood or marrow stem cells from a normal donor. However. some types of Hodgkin lymphoma.) of larger adult patients. (Numbers do not add up to 100% because of rounding. The harvesting. large localized areas of nonHodgkin lymphoma or with special complications that are amenable to radiation therapy may receive both primary chemotherapy and ancillary radiation therapy. Cord blood stem cell transplantation provides an additional donor pool and the opportunity for greater ethnic diversity in the blood supply because of collection efforts in hospitals where children of underrepresented ethnic backgrounds are born. Estimated New Cases (%) of Blood Cancers in 2007 Myeloma 15% Leukemia 33% Lymphoma 53% Treatment Chemotherapy and Radiotherapy: The use of chemotherapy (anticancer drugs). a search of the National Marrow Donor Program registry of tissue-typed volunteers could be made for a matched unrelated donor. for which a parent rather than a sibling could be the donor. which becomes abnormal (malignant) and multiplies continuously. slightly mismatched cord stem cell donors may be used quite successfully. The accumulation of malignant cells interferes with the body’s production of normal blood or immune cells and can result in severe anemia.About the Diseases Leukemia. If a sibling is not available. lymphoma and myeloma. Hodgkin and non-Hodgkin lymphoma and myeloma are cancers that originate in a cell in the bone marrow or lymphatic tissues. especially in young children. studies suggest that two matched cord donors may result in a higher success rate in larger adults. Approximately 50 different drugs are now being used in the treatment of these diseases. In special instances. Patients with leukemia. and the harvested cells may be treated with chemotherapy agents or monoclonal antibodies to decrease the presence of contaminating tumor cells before they are returned to the patient. The technique of harvesting stem cells from blood and cord blood has made transplantation available for more LEUKEMIA page 2 LYMPHOMA MYELOMA . Such an approach would greatly lessen the proportion of children without a donor. The numbers of stem cells in cord blood are often insufficient for the needs Figure 2: Source: Cancer Facts & Figures. especially for children. freezing and storing of cord blood have provided another source of stem cells for transplantation. Patients with acute lymphocytic leukemia (ALL). Autologous transplantation uses the patient’s own marrow stem cells and is technically not transplantation since another person is not the donor. The technique is important. is largely responsible for the dramatic improvement in managing leukemia and lymphoma. myeloma and lymphoma are usually treated with chemotherapy. There are two major types of stem cell transplants: syngeneic and allogeneic.
the recipient’s blood cell and immune system are preserved. Most follow-up clinics specialize in pediatric cancer survivors.childrensoncologygroup. Regular examinations may include screening for cancer recurrence or the development of secondary cancer or other late effects of treatment. The protein is an enzyme in the family of tyrosine kinases. Cancer survivors should see their primary care physicians for general health examinations and an oncologist for follow-up care related to cancer. lymphoma and myeloma.patients. New Approaches to Treatment Several areas of research have resulted in new approaches to the treatment of leukemia. Development of New Drugs: In the past decade.org/). The effectiveness and tolerance of older patients and the projections from the first five years of clinical trials in newly diagnosed patients suggest that the drug will prolong the duration of hematological remission and life when compared to former therapy. In standard stem cell transplantation. few severe adverse effects on normal tissues and a very high response rate. lymphoma or myeloma is attacked and suppressed by donor lymphocytes that form from the donor stem cells. Adolescent. It has been made possible by more effective immunosuppressive drugs that are capable of preventing rejection of the donor’s cells without full intensity treatment of the patient’s immune system. lymphoma or myeloma and permit the donor’s cells to be accepted by the temporarily immunodeficient recipient. Gleevec offers several dramatic advantages to patients: oral administration. Follow-Up Guidelines: The Children’s Oncology Group has established Long-Term Follow-Up Guidelines for Survivors of Childhood. To ensure there will be enough blood stem cells for successful transplantation. This “graft versus leukemia or lymphoma effect” can suppress (cure) the malignancy and is a prolonged (indefinite) form of immunotherapy. Over time. Identifying these biomarkers will allow researchers to develop tests that can predict what effects an individual is at risk of developing. Cancer survivors should have physical examinations yearly or more often. these cells can be harvested from the blood of a donor. Follow-Up Care Regular medical follow-up enables doctors to assess the full effect of therapy. making the procedure more tolerable. frozen and stored and later transplanted in the patient. marrow and immune system. In nonablative transplantation. Cancers (http://www. “Nonablative” allogeneic stem cell transplantation is the term applied to a technique of allogeneic transplant that uses lower doses of chemotherapy and/or radiotherapy to prepare the recipient for the donor’s stem cells. thereby allowing doctors to plan treatment accordingly. donors of blood stem cells require special treatment to mobilize sufficient stem cells from marrow into their blood before cells are harvested. Predictive tests: Research is under way to identify biomarkers that may indicate a higher-than-normal risk of developing a specific long-term or late effect. as well as marrow. Several organizations are working on evidence-based guidelines for adult blood cancer patients and their physicians that will standardize follow-up care and increase awareness about long-term and late effects. Some treatment centers have follow-up clinics that provide a comprehensive. Although a minority of patients have developed resistance to the drug. decreased side effects. as needed. Coordination between specialists and primary care physicians is essential to provide the best care possible. Stem cells not only reside in the marrow but also circulate in the blood. “Ablation” referred to wipingout the recipient’s cancer. It works by blocking the oncogeneencoded protein product that instigates the transformation to a leukemic cell. ablation of the recipient’s blood-cell forming and immune cells was the price that had to be paid to eradicate the leukemia. Blood and cord blood transplants differ from marrow transplants principally in the source of the cells collected for transplant. several important new drugs and new uses for existing drugs have greatly improved cure rates or remission duration for some patients with leukemia. identify recurrence of the disease and detect long-term or late effects. multi-disciplinary approach to monitoring and supporting cancer survivors. Biomarkers could be high levels of certain substances in the body such as antibodies or hormones. but some follow adult cancer survivors. is a source of stem cells for transplantation. two second-generation agents. This still experimental approach greatly lessens the early toxicity of transplantation and has extended the age at which recipients with leukemia. the donor’s cells take hold and the patient’s leukemia. or genetic factors that can increase susceptibility to certain effects. and Young Adult LEUKEMIA LYMPHOMA MYELOMA page 3 . Imatinib mesylate (Gleevec®) is now the drug of choice in newly diagnosed patients with chronic myelogenous leukemia (CML). lymphoma or myeloma can have an allogeneic transplant. Because blood.
PDGFR or KIT oncoproteins). reducing the need for transfusions in some patients. a thalidomide derivative. however. the most prevalent lymphoma subtype. cyclophosphamide. principally. thalidomide (Thalomid®). Food and Drug Administration [FDA] in 2006) and nilotinib (in clinical trials). Rituximab is an antibody directed at the target CD20 antigen on B-cell lymphoma cells. Alemtuzumab (Campath®) is a monoclonal antibody directed against the antigen CD52 found on T and B lymphocytes. Azacitidine (Vidaza®). immune cell administration and vaccine development. has improved dramatically with the introduction of cladribine. Clofarabine (Clolar®). In May 2006. Three types of immunotherapy are being explored: antibody treatment. The treatment of hairy cell leukemia. Monoclonal antibodies have added to the arsenal of agents that are used for the treatment of patients with lymphoma and leukemia. Trials are under way to determine if one of these second-generation drugs should become the drug of choice to initiate therapy and if the use of two drugs would be better than one. Immunotherapy: This is a treatment that uses immune cells or antibodies to fight the disease. is being used to treat relapsed or refractory acute lymphocytic leukemia (ALL) in children who have received at least two prior therapies. The remission rate and duration of remission of acute promyelocytic leukemia (APL) has been improved significantly with the introduction of all-trans retinoic acid in combination with chemotherapy (anthracycline antibiotic). Indeed. occasional cases of chronic myelomonocytic leukemia (CMML) and in systemic mastocytosis because patients with these conditions have a genetic abnormality that results in an abnormal tyrosine kinase that is blocked by imatinib (mutant ABL. a less common type of chronic lymphocytic leukemia (CLL). but it can also induce remissions in some cases of acute leukemia. but without this specific chromosome 5 abnormality.S. suppresses the progression of leukemia. Revlimid is approved by the FDA in combination with dexamethasone for the treatment of myeloma patients who have received at least one prior therapy. Two additional drugs being studied in clinical trials have shown responses in a subset of patients with myeloma: the proteasome inhibitor bortezomib (Velcade®) and the immune modulator (Revlimid®). Rituximab has become an important agent to treat CD20-positive lymphocytic malignancies. has been approved by the FDA for the treatment of a specific type of myelodysplastic syndrome (MDS) that results from an alteration in chromosome 5. Gleevec is not only a very important new agent in the treatment of CML. approved by the FDA in 2005. doxorubicin (Adriamycin®). Pentostatin is another effective drug that can be used in patients with hairy cell leukemia who do not respond to cladribine. LEUKEMIA page 4 LYMPHOMA MYELOMA . vincristine (Oncovin®) and prednisone–therapy for diffuse large B-cell lymphoma. it has now become an important fifth drug in the R-CHOP–rituximab. symptomatic anemia have improvement in hemoglobin levels with this agent. approved by the FDA for all types of MDS. lymphoma or myeloma. Early studies indicate the combination of arsenic trioxide and all-trans retinoic acid may be a further advance in the initiation of therapy. farnesyl transferase inhibitors and reduced-intensity stem cell transplantation. kill unhealthy bone marrow cells and may help the bone marrow function more normally in MDS patients. chronic eosinophilic leukemia (formerly hypereosinophilic syndrome). Lenalidomide (Revlimid®). This drug is also being tested in clinical trials to treat adult acute leukemia and MDS. and Decitabine (Dacogen®). such as follicular lymphoma. Bendamustine (TreandaTM) is showing promising results in clinical trials to treat indolent non-Hodgkin lymphoma that does not respond to rituximab (Rituxan®) neither as a single agent nor in combination with chemotherapy. perhaps 20 percent of cases also derive benefit. are entering clinical use and can overcome this resistance in some cases. Other therapies in clinical research to treat MDS include arsenic trixoxide. and enhances the specificity of treatment to minimize toxic effects on normal tissues. Patients with more severe forms of MDS are very unlikely to respond to the agent. thus rituximab is an anti-CD20 antibody. Cladribine induces long-term remissions in nearly 90 percent of patients treated at diagnosis for one week. Velcade is approved by the FDA for treating people with myeloma who have had at least one prior therapy.dasatinib (Sprycel®)(approved by the U. Some patients with moderately severe. It is especially active against the lymphocytes in CLL. In patients with anemia. Monoclonal Antibody Therapy: Monoclonal antibodies are laboratory-produced proteins that can be infused into an appropriate patient. was approved by the FDA for newly diagnosed myeloma. in combination with dexamethasone. Arsenic trioxide also adds to the drugs available to treat this subtype of acute leukemia. although initially used in indolent lymphomas. Cell surface antigens have been given a cluster designation (CD) followed by a number.
These agents are currently being tested in patients with AML and myeloma in the hope that they may decrease drug resistance and increase the rate of a prolonged response to therapy. LEUKEMIA LYMPHOMA MYELOMA page 5 . and aptamer treatment. In another approach. This means that the vaccine induces an immune response against the cancer cells present in the patient. These types of vaccines would be used in patients who have small amounts of residual blood cancer after chemotherapy or stem cell transplantation. the patient’s immune cells would be treated in the laboratory to train them to attack the residual leukemia. myeloma and leukemia. An alternative strategy called molecular targeted drug development targets the oncoprotein. the infusion of the original marrow donor’s lymphocytes can re-induce remission. some vaccines are made from leukemic cells treated in test tubes to convert them to potent antigen-presenting cells. Two new and potentially important approaches include a) the application of RNA interference. lymphoma and myeloma.Another antibody that has been approved for use by the FDA to treat certain patients with acute myelogenous leukemia (AML) is linked to a chemical toxin called calicheamicin. cells are isolated in the laboratory and start making antibodies after insertion of the cancer antigen. new forms of cancer therapy may be developed. gemtuzumab (Mylotarg®). This type of treatment is being studied intensively to learn more about the basis for this immune cell effect and to expand it for use in other situations. or become. In some approaches. These are called conjugated monoclonal antibodies. gene therapy researchers are trying to modify an oncogene (BCR-ABL) that produces a protein that stimulates malignant cell growth. They deliver the toxic substance directly to the cancer cells. Vaccines are in clinical trials for types of acute and chronic leukemia. Vaccines: Experimental treatment vaccines are now being studied to treat certain types of lymphoma. lymphoma or myeloma cells. These cells are. If the gene in the former case is an oncogene or the protein in the latter case is an oncoprotein. a technique that prepares small molecules in the laboratory that have the ability to inactivate proteins that cause disease. Examples of this treatment are the drugs ibritumomab (Zevalin®) and tositumomab and iodine I131 tositumomab (Bexxar®). DNA vaccines that contain the DNA that encodes the specific antigen are being tested. The goal of several new agents being studied is to decrease resistance to an important chemotherapy drug used in leukemia. Some vaccines contain antigens or parts of antigens purified from cancer cells obtained from the patient or from the same type of cancer cells but obtained from another patient. Reversal of Multidrug Resistance: The malignant cells of patients have mechanisms that may allow them to escape the damaging effects of chemotherapy agents. These agents can act on the gene (DNA) or on RNA to prevent the formation of the gene product or protein (oncoprotein) that is the direct cause of transforming the cell into a malignant type. These drugs have been approved to treat relapsed B-cell non-Hodgkin lymphoma. less responsive to therapy. Many cancer treatment vaccines under development are intended to induce antigen-specific antitumor immune responses. drugs are designed to interfere with the oncoprotein and prevent its effect on the cell. Patients with myeloma have also had remission re-induced by donor lymphocytes. Approaches to reversing multidrug resistance are under study. In patients with CML who have relapsed after stem cell transplantation. These antibodies are injected into the patient in the hope that the antibodies will latch on to the antigen on the cancer cells and destroy the cells. In one approach. Studies of vaccines used in patients with follicular or indolent lymphoma have demonstrated an immune response. This drug. Monoclonal antibodies can also be linked to a radioactive isotope to target and kill specific cancer cells. Gene Therapy: One approach to this type of treatment is to use “antisense” agents that block the encoding instructions of an oncogene so that it cannot direct the formation of the corresponding oncoprotein that causes the cell to transform into a malignant cell. In studies of CML. In each case. Paradoxically. is approved for older patients with AML who relapse after initial treatment. b) a modality that uses molecules of RNA to silence complementary (DNA) genes. The goal is to extend the duration of remission achieved by remissioninduction therapy of various types. the basis for the vaccine is to make the cancer cells susceptible to immune attack by heightening the recognition of markers on the cancer cells.
Table 3: Source: Cancer Facts & Figures 2007. Epidemiology. functionless cells in the marrow and blood.289 Total Estimated Number of New Leukemia Cases in the United States for 2007 Type Acute lymphocytic leukemia Chronic lymphocytic leukemia Acute myelogenous leukemia Chronic myelogenous leukemia Other forms of leukemia Total Individuals 5. National Cancer Institute. • About 33 percent of cancers in children aged 0-14 years are leukemia • Most cases of chronic myelogenous leukemia (CML) occur in adults. red blood cells and white blood cells.S.000 2.S. The lack of normal white cells impairs the body’s ability to fight infections. Leukemia is divided into four categories: myelogenous or lymphocytic. The Four Major Types of Leukemia Acute lymphocytic leukemia Acute myelogenous leukemia Table 1 Chronic lymphocytic leukemia Chronic myelogenous leukemia Living with Leukemia An estimated 218. develops in virtually all leukemia patients. Surveillance Research Program.440 adults compared with 3. 1. Approximate U. 2007.140 6.000 population.570 3. based on the November 2006 SEER data submission. A shortage of platelets results in bruising and easy bleeding. In 2007.150 24. New Cases An estimated 44. The marrow often no longer produces enough normal platelets. The four major types of leukemia are shown in Table 1. Leukemia is expected to strike more than 10 times as many adults as children in 2007. DCCPS. *Note: Incidence rates are the number of new cases in a given year not counting the preexisting cases. Acute leukemia is a rapidly progressing disease that results in the accumulation of immature.240 new cases of leukemia will be diagnosed in the United States this year. NCI. Chronic leukemia progresses more slowly and allows greater numbers of more mature.060 8. The incidence rates are usually presented as a specific number per 100.720 44. It is characterized by the uncontrolled accumulation of blood cells.) • The most common types of leukemia in adults are acute myelogenous leukemia (AML) and chronic lymphocytic leukemia (CLL). more than half of all cases occur after age 67. • Most cases of leukemia occur in older adults.570 19.380 6.800 Female 2. *Prevalence estimates are expressed here as the number of people living in whom the first involved tumor for each cancer site was diagnosed during the previous 29 years. Statistical Research and Applications Branch.410 4. Nearly 54 percent of the new cases of this disease will occur among children in 2007 (about 2.570 5. 2007. Chronic leukemias account for 7 percent more of the cases than acute leukemias. Estimated 29-Year L-D Prevalence Counts on 1/1/2004 by Duration. American Cancer Society. The terms myelogenous or lymphocytic denote the cell type involved. each of which can be acute or chronic. functional cells to be made.340 13.960 7.200 15.800 children. aged 0-19.350 2.060 2.790).579 21.189 27. Prevalence of the Four Major Leukemias as of Jan. males are expected to account for 56 percent of the new cases of leukemia.4 percent of leukemias in children aged 0-19 are CML. Only 2.659 people in the United States are living with leukemia. (About 40. and SEER Program. Prevalence database: U. a deficiency of red cells. and End Results) Cancer Statistics Review 1975-2004.240 Male 3. Incidence by Gender Incidence rates* for all types of leukemia are higher among males than among females. 2004 Type Chronic lymphocytic leukemia Chronic myelogenous leukemia Acute lymphocytic leukemia Acute myelogenous leukemia Prevalence* 95.501 50. released April 2007.440 Table 2: Sources: SEER (Surveillance.Leukemia Leukemia is a malignant disease (cancer) of the bone marrow and blood. • The most common form of leukemia in children is acute lymphocytic leukemia (ALL). LEUKEMIA page 6 LYMPHOMA MYELOMA . Anemia.
the incidence of AML slowly rose while that of ALL steadily decreased in the period from late adolescence to older adulthood. Adults.to 19-year olds. However. eighth and ninth decades of life.900 new cases of cancer diagnosed in African-Americans in 2007. Other 13% ALL 12% CM L 10% CLL 35% A ML 30% There is optimism within centers that specialize in the treatment of children because survival statistics have dramatically improved over the past 30 years. Leukemia strikes all ages and both sexes.922 cases per year. Possible Causes of Leukemia Anyone can get leukemia. Leukemia rates are substantially higher for Hispanic. Leukemia incidence is highest among whites and lowest among American Indians/Alaskan natives.790 new cases of childhood ALL are expected to occur in 2007.800 children will be diagnosed with leukemia throughout the United States. In 25. there were 4.5 times that of ALL. was 504 per 100. The most common form of leukemia among children under 20 years of age is ALL. from 2000-2004. including the examination of the cells in blood or marrow. The leukemias represented 27 percent of all cancers occurring among children younger than 20 years from 2000-2004.799 children under the age of 20 diagnosed with leukemia from 2001-2004.Estimated Proportion of New Cases (%) in 2007 for Each Type of Leukemia Including Adults and Children 3. Hispanic children of all races under the age of 20 have the highest rates of leukemia. The incidence rate for all cancers among AfricanAmericans in the Seer (17 region). The incidence of ALL among 1. white and Asian/Pacific islander children than for black children. From 1975 to 2000. Although chronic exposure to benzene in the workplace and exposure to extraordinary doses of irradiation can be causes of the disease. It is estimated that in 2007. Incidence by Race and Ethnicity Incidence rates for all types of cancer combined are more than 5 percent higher among Americans of African descent than among those of European descent. neither explains most cases. including 3. CLL incidence increases dramatically among people who are aged 50 and older. The American Cancer Society estimates that there will be approximately 152. Most children under 15 years of age with ALL are cured. LEUKEMIA LYMPHOMA MYELOMA page 7 . 2007. CML incidence also increases dramatically among people who are aged 60 and older. These signs are not specific to leukemia and may be caused by other disorders. American Cancer Society.to 29-year olds. Leukemia is one of the top 15 most frequently occurring cancers in minority groups. Adolescents and Young Adults. About 2. American Indian/Alaskan natives. Some people with chronic leukemia may not have major symptoms and are diagnosed during a medical examination. Signs and Symptoms of Leukemia Signs of acute leukemia may include • Easy bruising or bleeding (because of platelet deficiency) • Paleness or easy fatigue (because of anemia) • Recurrent minor infections or poor healing of minor cuts (because of inadequate white cell count). leukemia rates are higher in Americans of European descent than among those of African descent.to 4-year-old children is more than nine times greater than the rate for young adults ages 20 to 24. ALL incidence was approximately twice that of AML. AML incidence was approximately 1. Among 15. Figure 3: Source: Cancer Facts & Figures 2007. The diagnosis of leukemia requires specific blood tests. In the 17 SEER regions of the United States. The cause of leukemia is not known. Incidence by Age-Group Incidence rates by age differ for each of the leukemias.000 population. They do warrant medical evaluation. Children. averaging about 189. These cancers are most prevalent in the seventh.619 with ALL. and AML incidence increases dramatically in people who are aged 60 and older.
8 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85+ Age in Years Figure 4: Sources: SEER (Surveillance. By 1975-1977. During 1996-2003. the five-year relative survival rate had jumped to 35 percent. the overall relative survival rate was nearly 50 percent. In 1960-1963.7 percent overall.1 Incidence (per 100.3 percent overall. gender. when compared to a person without leukemia. a complete remission (no evidence of disease in the blood or marrow) that lasts five years after treatment often indicates cure. National Cancer Institute. All Types Leukemia.8 1-4 0.2 23 21 19 19. Thirty-two percent more males than females are living with leukemia.1 for children under 15 • CML: 44.2 10. 2007.6 10-14 0.3 3. 2000-2004 25 23.9 20-24 0. 54. Epidemiology and End Results) Cancer Statistics Review 1975-2004. The five-year relative survival rate has more than tripled in the past 47 years for patients with leukemia. National Cancer Institute.4 5-9 0.Age-Specific Incidence Rates for Acute Myelogenous Leukemia (All Races). Relapse indicates return of the cancer cells and the return of other signs and symptoms of the disease. For acute leukemia.4 percent for children under 5 • CLL: 74. The relative survival rates differ by age of the patient at diagnosis.2 15 13 11 9 7.2 1. LEUKEMIA page 8 LYMPHOMA MYELOMA . Treatment centers report increasing numbers of patients with leukemia who are in complete remission at least five years after diagnosis of their disease.4 percent Five-Year Relative Survival Rates for All Ages.1 4. Treatment of Leukemia The aim of treatment is to bring about a complete remission. and in 1996-2003.3 1.4 <1 0. 2007.000) 17 15.8 percent • AML: 20. Survival Rates 40% 30% 20% 10% 0% 35% 1975-77 1978-80 1981-83 1984-86 1987-89 1990-92 1993-95 1996-2003 Years Figure 5: Sources: SEER (Surveillance.7 7 5 3 1 0 1. Epidemiology and End Results) Cancer Statistics Review 1975-2004. 90. race and type of leukemia. Complete remission means that there is no evidence of the disease and the patient returns to good health with normal blood and marrow cells.5 21. 1975-2003 50% 42% 38% 39% 44% 47% 48% 50% Survival Relative survival compares the survival rate of a person diagnosed with a disease with that of a person without the disease. a patient had a 14 percent chance of living five years.6 2.9 25-29 1. the five-year relative survival rates overall were: • ALL: 65.9 15-19 0.
deaths from leukemia are expected to be distributed in the following numbers: In 2007. leukemia will be the fifth most common cause of cancer deaths in men and the sixth most common in women.020 240 3.710 9. 2. National Cancer Institute. In 2007. Estimated Deaths (All Age Groups) from All Types of Leukemia in 2007 Type Acute lymphocytic leukemia Chronic lymphocytic leukemia Acute myelogenous leukemia Chronic myelogenous leukemia Other.470 females. African-Americans who were diagnosed with leukemia between the ages of 25 and 44 had the highest death rates from the disease during this period. Blood. Hispanics with leukemia who are under the age of 25 had the highest mortality rates from the disease between 1990 and 1999.320 Female 600 1. American Cancer Society.420 deaths from ALL. Zuelzer WW.680 12. about 515 children under the age of 14 are expected to die from leukemia.990 deaths from AML and 490 deaths from CML. LEUKEMIA LYMPHOMA MYELOMA page 9 .790 Male 820 2. Survival Rates 50% 40% 30% 20% 10% 0% 19641 197519772 197819802 198119832 198419862 198719892 199019922 199319952 199620032 3% Years Figure 6: The graph shows childhood ALL five-year relative survival rates have improved significantly over the past nearly 40 years.560 5. 1975-2004.940 3. SEER (Surveillance.390 additional deaths.390 21. Cancer Statistics Review.Five-Year Relative Survival Rates for Acute Lymphocytic Leukemia. The leukemia death rate for children from 0 to 14 years in the United States has declined about 70 percent over the past three decades. Despite this decline.500 deaths from CLL and 1. Deaths It is anticipated that approximately 21. 2007. 1964-2003 90% 80% 70% 60% 58% 71% 66% 73% 78% 83% 84% 87% The estimated numbers of deaths attributed to leukemia in the United States are 30 percent higher for males than for females. 2007.970 250 2. 1964:24:477-494.420 4. There will be an estimated 4. unclassified forms of leukemia Total Overall 1.320 males and 9. in Children Under 15 Years of Age. Implications of long-term survivals in acute stem cell leukemia of childhood treated with composite cyclic therapy. leukemia causes more deaths than any other cancer among children and young adults under age 20.990 490 6. In 2007.500 8. Unclassified forms of leukemia will account for 6.790 deaths in the United States will be attributed to leukemia in 2007: 12.470 Table 4: Source: Cancer Facts & Figures 2007. There will be an estimated 8. Epidemiology and End Results). Non-Hispanic whites diagnosed with leukemia over the age of 44 had the highest death rates during this period. Sources: 1.
Hodgkin lymphoma are higher in Americans of European descent than among those of African descent.S.313 people living with Hodgkin lymphoma (active disease or in remission) and 405.710 Total 8. there are 138. while 0.000 for females. including the presence of an abnormal cell called the ReedSternberg cell (a large. The bacterium Helicobacter pylori is associated with the development of lymphoma in the stomach wall. rose by 84 percent from 1975 to 2004.190 63.190 cases of non-Hodgkin lymphoma). incidence rates for non.7 percent of all cases of non-Hodgkin lymphoma will be diagnosed in children under 15 years of age this year. or low.000 for females.953 people living with nonHodgkin lymphoma for a total of 544.720 28.470 34. population who are living with lymphoma. Incidence rates for Hodgkin lymphoma tend to be higher among males than among females. By ages 60 to 64. Persons infected with the human immunodeficiency virus (HIV) have a much higher risk of developing lymphoma.6 per 100. eventually crowding out healthy cells and creating tumors that enlarge the lymph nodes or other sites in the body. New Cases of Lymphoma by Gender. Age-specific incidence rates of non-Hodgkin lymphoma are 2.266 members of the U. Non-Hodgkin Lymphoma Non-Hodgkin lymphoma represents a diverse group of cancers with the distinctions between types based on the characteristics of the cancerous cells.380 Americans will be diagnosed with lymphoma in 2007 (8. the difference was small. Living with Lymphoma In the United States in 2007.200 38.Lymphoma Lymphoma is a general term for a group of cancers that originates in the lymphatic system. It is the sixth most common cause of cancer deaths in males and in females.990 32. In 2004. After 50 to 54 years of age.000 at ages 20 to 24 for males and 1. American Cancer Society.5 percent of all lymphomas diagnosed in 2007. 2007.000 for males and 38. LEUKEMIA page 10 LYMPHOMA MYELOMA .9 per 100. These risk factors explain only a small proportion of cases.670 Female 3. they are 52.190 cases of Hodgkin lymphoma and 63. The age-adjusted incidence of non-Hodgkin lymphoma Incidence by Race and Ethnicity Although blacks in their mid 20s to late 40s have higher incidence rates of non-Hodgkin lymphoma than whites. in general whites have higher incidence rates than blacks. Each histologic grouping is diagnosed and treated differently. The Epstein-Barr virus causes Burkitt’s lymphoma in Africa. The groups are often classified as indolent or aggressive. Hodgkin Lymphoma Hodgkin lymphoma is a specialized form of lymphoma and will represent about 11.3 per 100. The incidence of Hodgkin lymphoma is consistently lower than that of non-Hodgkin lymphoma.190 71.380 Table 5: Source: Cancer Facts & Figures 2007. The reasons for the development of non-Hodgkin lymphoma are not certain. Both Hodgkin and non-Hodgkin lymphomas are more common in males than in females. New Cases About 71. Lymphoma results when a lymphocyte (a type of white blood cell) undergoes a malignant change and begins to multiply. Incidence by Gender Table 5 illustrates the breakdown of incidence of lymphoma by gender. intermediate and high grade.8 percent. Fifty-three percent of the blood cancers diagnosed are lymphomas. Immune suppression plays a role in some patients. More than four percent of all cases of Hodgkin lymphoma diagnosed in 2007 will be in children under 15 years of age. and each has prognostic factors that categorize it as more or less favorable. an average annual percentage increase of 2. Non-Hodgkin lymphoma is the fifth most common cancer in males and females in the United States.9 per 100. 2007 Type Hodgkin lymphoma Non-Hodgkin lymphoma Total Male 4. malignant cell found in Hodgkin lymphoma tissues). Hodgkin lymphoma has characteristics that distinguish it from all other cancers of the lymphatic system.
000 children in 2004. About 2.1 per 100. recurrent high fever. From ages 15 to 19.1 cases per 100. Survival for Adults Hodgkin lymphoma is now considered to be one of the most curable forms of cancer. Hispanics of all races have the second highest incidence rates of non-Hodgkin lymphoma after whites. Symptoms also often include fever. troublesome itching and weight loss. depending on the tumor size. In children from 0 to 19 years of age. most children with nonHodgkin lymphoma did not live five years after diagnosis. localized non-Hodgkin lymphoma is sometimes treated with radiation. Hodgkin lymphoma incidence rates are higher in adolescents and young adults than in adults in their middle years. It is rarest among American Indian/ Alaskan native children. chemotherapy or both may result in cures for most patients with Hodgkin lymphoma. persistent fatigue. excessive tiredness. 1. The five-year relative survival rate for patients with Hodgkin lymphoma has more than doubled from 40 percent in whites in 1960-1963 to more than 86 percent for all races in 1996-2003.000 persons at ages 80 to 84. and more than 46-fold to 112. Treatment for non-Hodgkin lymphoma sometimes includes vaccines and other forms of immunotherapy.5/1 million population). Signs and Symptoms Signs and symptoms of Hodgkin lymphoma include painless swelling of lymph nodes in the neck. In children under 20 years of age. Adolescents are more commonly diagnosed with Hodgkin lymphoma than young children. groin or in the abdomen. Even in the mid-1970s. Deaths An estimated 19. Non-Hodgkin lymphoma is the fifth most common cancer in Hispanics.000 by ages 60 to 64. and non-Hodgkin lymphoma. In the United States. Death rates have been declining for Hodgkin lymphoma patients since the mid-1970s.5 percent) are the third most common cancers in children.2 percent for Hodgkin lymphoma in people under 20 years of age.730 persons will die from lymphoma in the United States in 2007 (18. following leukemia (26. armpit. lymphomas are most commonly diagnosed in whites (24. This represents a significant improvement in the rate of recovery.to 24year-old individuals. and is the eighth most common cause of cancer death in that group. Non-Hodgkin lymphoma is the ninth most common cause of cancer death in males and the seventh in females in the United States.9 percent). Incidence in Children The incidence of Hodgkin lymphoma among people under 20 years of age was 1.8 percent) and neoplasms of the brain and other nervous tissue (17. loss of appetite and bone pain.1 cases per 100. sweating at night. widespread disease requires chemotherapy or chemotherapy and/or monoclonal antibody therapy with radiation. The incidence in this group decreased almost steadily and significantly between 1975 and 1999. In children up to age 14 years. five-year relative survival for non-Hodgkin lymphoma is now 83. Radiation.Among women.0/1 million population).5 percent. Lymphomas (Hodgkin lymphoma.660 from non-Hodgkin lymphoma. armpit or groin. Incidence in Adults The incidence of non-Hodgkin lymphoma increases with age.5 percent. the highest incidence of non-Hodgkin lymphoma is in Asian/Pacific islanders. LEUKEMIA LYMPHOMA MYELOMA page 11 . comprising nearly 5 percent of all cancers diagnosed. Early stage.400 children under the age of 15 will be diagnosed with cancer in 2007. It has remained fairly constant since 1999.000 people occur in 20.8 percent for all races in 1996-2003.4 cases per 100. The most common early sign of other forms of lymphoma is also painless swelling of the lymph nodes – usually in the neck. about 10. night sweats. the highest incidence of non-Hodgkin lymphoma is in non-Hispanic whites. followed closely by Hispanic children of all races (24. indigestion and abdominal pain. 3. Treatment Hodgkin lymphoma is often treated with radiation and chemotherapy. Survival for Children Five-year relative survival is 95. The five-year relative survival rate for non-Hodgkin lymphoma patients has risen from 31 percent in whites in 1960-1963 to 63.070 from Hodgkin lymphoma). cell type and location of the lymphoma. The rate increases more than 18 times to 45. 4. Five-year relative survival is now 95 percent for Hodgkin lymphoma in children aged 0 to 14 years.
370 Female 300 9.9 1. 2000-2004 6 Incidence (per 100.070 18. Age-Specific Incidence Rates for Non-Hodgkin Lymphoma.5 10. 2007.730 Male 770 9. National Cancer Institute.8 2.000) 5 4 3 2 1 0 0.9 4.0 100.600 10.0 2. Trends in Five-Year Relative Survival Rates by Race for Hodgkin Lymphoma and Non-Hodgkin Lymphoma Hodgkin Lymphoma All races Whites African-Americans 1975-77 1981-83 74% 74% 71% 76% 76% 73% 1990-92 1996-2003 83% 84% 74% 86% 87% 81% Estimated Deaths by Gender from Hodgkin Lymphoma and Non-Hodgkin Lymphoma Type Hodgkin lymphoma Non-Hodgkin lymphoma Total Overall 1. * <16 cases for time interval. Table 6: Source: SEER (Surveillance. Epidemiology and End Results) Cancer Statistics Review 1975-2004. American Cancer Society.1 4.8 3.4 80.Age-Specific Incidence Rates for Hodgkin Lymphoma.6 0.9 7. 2000-2004 110 100 90 80 Incidence (per 100.4 3. LEUKEMIA page 12 LYMPHOMA MYELOMA .0 45.060 9.0 0.4 2.000) 70 60 50 40 30 22.0 20 10 0 0.9 3. National Cancer Institute.5 <1* 1-4 5-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 Age in Years 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85+ Figure 8: Sources: SEER (Surveillance.4 4.1 0.4 2.8 112. *<16 cases per time interval. Epidemiology and End Results) Cancer Statistics Review 1975-2004.1 102.1 63. 2007.8 4.6 32.3 4. Epidemiology and End Results) Cancer Statistics Review 1975-2004.660 19.3 <1* 1-4 5-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85+ Age in Years Figure 7: Sources: SEER (Surveillance.0 1.1 3.360 Non-Hodgkin Lymphoma All races Whites African-Americans 1975-77 48% 48% 49% 1981-83 1990-92 1996-2003 53% 53% 50% 52% 53% 42% 64% 65% 56% Table 7: Source: Cancer Facts & Figures 2007.2 4. 2007.4 15.1 3.4 2.2 1.1 0.0 3.4 2. National Cancer Institute. 2007.
20-24). a type of white blood cell found in many tissues of the body. (11. Sixty percent of those were diagnosed with the disease within the past four years.000 to 3. 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85+ Age in Years Possible Causes The cause of myeloma is not known. Total survival for white males.1/100. LEUKEMIA LYMPHOMA MYELOMA page 13 . but it is the most difficult blood cancer to treat successfully.900 (10. Usually.4 35.1 Signs and Symptoms Often the first symptom of myeloma is bone pain caused by the effects of myeloma cells in the marrow. becomes malignant.000).3 0.1 5. Approximately 3 percent of all cancer-related deaths among AfricanAmericans in 2000-2004 were from myeloma. 2000-2004 Incidence (per 100. tire more easily and feel weak. Treatment may include intensive chemotherapy followed by stem cell transplantation to restore normal blood cell production.8 14. National Cancer Institute. It is 71 for African-Americans.790 deaths from myeloma are anticipated this year. The highest rates are found in black men 80 to 84 years of age and older (105/100. destroying normal bone tissue.000).000) 40 30 20 10 0 0-24 0. The mortality rate from myeloma for people of African descent is more than double the rate for whites (7. From 2000 to 2004. Epidemiology and End Results) Cancer Statistics Review 1975-2004.000) is 56 percent higher than for women (4. Recurrent infections may be an early sign of the disease.000) of myeloma than those of European descent (5.1 21. • The incidence rate in men (7/100. 10-14. has been increasing.000) for all racial and ethnic groups. *<16 cases for each age interval. At times. Age-Specific Incidence Rates for Myeloma. especially. It grows continuously and forms masses of plasma cells. • Americans of African descent have a much higher incidence rate. Thalidomide is approved by the FDA for use in treating newly diagnosed myeloma. 5-9. Deaths Approximately 10. Treatment Chemotherapy for myeloma has led to sustained remissions in some patients. especially in the marrow. SEER 17 areas (<1. median age at death from multiple myeloma is 74. • The median age at diagnosis for African-Americans is 67. myeloma was the 10th most commonly diagnosed cancer among African-American men and women. Treatment is aimed at slowing progress of the disease. The onset of myeloma interferes with normal production of antibodies and makes myeloma patients susceptible to infections.960 men and 8.7 1.2/100.1 28. Fractures may occur as a result of the weakened bones. the cell that forms plasma cells. Lenalidomide is approved by the FDA in combination with dexamethasone for the treatment of myeloma patients who have received at least one prior therapy.Myeloma Myeloma is a cancer of the plasma cells.940 women) new cases of myeloma will be diagnosed in the United States in 2007. 2007.5/100.4 33. a B lymphocyte. In myeloma. Bortezomib has been approved for treating myeloma in patients who have had at least two prior therapies. Malignant plasma cells produce an abnormal protein called monoclonal immunoglobulin. Living with Myeloma An estimated 60. the patient’s own stem cells are used (autologous stem cell infusion).S. Immunoglobulins (or antibodies) are an important part of the body’s natural defense against infection because they recognize microbes that invade the body and permit them to be removed and destroyed.424 people in the United States are living with myeloma. but primarily in the bone marrow. Survival Current statistical databases show that overall five-year relative survival in patients with myeloma has shown a significant improvement since the 1960s: 12 percent in 1960-1963 for whites to 34 percent from 1996-2003 for all races. • The median age at diagnosis is 70. New Cases An estimated 19. The U.5 3. Figure 9: Source: SEER (Surveillance.000).0 37.3/100. 15-19.9 9. Patients may have anemia. two or three drugs are used simultaneously. 1-4. and it rarely occurs in people under age 45. approximately double. causing pain and crowding out normal blood cell production.5/100. Myeloma was the 10th most common cause of cancer deaths for women in 2000-2004.1 0.
3 2.6 2. per 100.Incidence Rates: Leukemia.2 14.2 2.) Table 9: Source: SEER (Surveillance.2 18.0 23. Epidemiology and End Results) Cancer Statistics Review 1975-2004.000 Population (2000-2004) Type Leukemia Non-Hodgkin lymphoma Hodgkin lymphoma Myeloma Overall 10.9 17. (Based on SEER 17 areas.7 5.000 Population (2000-2004) Type Leukemia Non-Hodgkin lymphoma Hodgkin lymphoma Myeloma Overall 12. per 100. All Races. National Cancer Institute.6 Female 9.3 Male 13. Rates are per 100.1 2.6 4.3 19. for Whites.5 16. National Cancer Institute. Lymphoma and Myeloma The following tables showing incidence rates for leukemia.0 7.6 Male 16.2 Male 16. (Based on SEER 17 areas.3 2.2 6. 2007. Incidence Rates by Gender.1 9. for Blacks.5 Incidence Rates by Gender.) LEUKEMIA page 14 LYMPHOMA MYELOMA .5 Table 8: Source: SEER (Surveillance.0 Female 8. (Based on SEER 17 areas. 2007.1 11.7 24.2 3.9 5.4 11.1 Table 10: Source: SEER (Surveillance.000 Population (2000-2004) Type Leukemia Non-Hodgkin lymphoma Hodgkin lymphoma Myeloma Overall 12. Epidemiology and End Results) Cancer Statistics Review 1975-2004.) Incidence Rates by Gender. per 100.8 20.0 Female 9. Hodgkin and non-Hodgkin lymphoma and myeloma use figures from 2000-2004.1 3. the most recent available.8 14.4 4.000 population and are age-adjusted to the 2000 population.9 2. Epidemiology and End Results) Cancer Statistics Review 1975-2004.0 2. National Cancer Institute. 2007.
Note: These estimates are offered as a rough guide and should be interpreted with caution. Numbers are rounded to the nearest 10.130 300 80 900 960 300 1.260 220 400 420 290 2.410 130 50 500 490 130 490 * 21.S. ***Hodgkin lymphoma estimates are not available for 2007. of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Total** 350 * 400 240 2.250 1. *Estimate is fewer than 50 cases.370 250 280 2.040 70 44.660 210 * 190 120 1. January/February 2007. American Cancer Society. total because of rounding and exclusion of estimates that are fewer than 50 cases.390 1.190 290 * 280 200 1. Numbers are rounded to the nearest 10. National Center for Health Statistics.610 670 610 110 60 3.540 1.310 800 600 900 920 330 1.170 480 1.830 240 230 60 * 1.370 100 * 430 380 130 350 * 19. Centers for Disease Control and Prevention.240 740 80 1. They cannot be compared with previous years’ estimates to determine cancer incidence trends.560 770 890 3. by State. Used with permission. **State estimates may not add up to U. *Estimate is fewer than 50 cases.070 Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Dist. Mortality Public Use Data Tapes.S. 2006.070 80 330 70 480 1.520 310 3. The method of derivation. and additional data supplied by the American Cancer Society based on data from the U.050 140 140 * * 680 310 * 50 440 240 130 120 170 180 60 220 250 420 190 110 240 50 70 80 50 270 70 650 360 * 460 120 160 550 * 200 * 270 720 70 * 250 220 70 200 * 10. total because of rounding and exclusion of estimates that are fewer than 50 cases.630 540 80 120 990 510 310 230 320 330 100 390 490 770 400 210 460 80 150 160 100 680 120 1.670 1.360 960 170 220 2. is described by Pickle et al.140 380 140 1. 2007 State Leukemia Non-Hodgkin Lymphoma Myeloma Hodgkin Lymphoma Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Dist.080 1. 2007.330 260 780 180 1.300 470 90 100 750 430 300 220 290 310 110 320 420 660 350 170 500 80 110 130 90 600 120 1. Used with permission.140 60 260 80 410 1.190 880 870 170 100 4.030 570 * 610 210 360 1.S.360 610 * 950 290 260 1.010 1.790 330 * 320 200 1. **State estimates may not add up to U. model (see below). CA A Cancer Journal for Clinicians. Note: These estimates are offered as a rough guide and should be interpreted with caution.070 110 1.030 910 620 420 680 680 250 630 1. American Cancer Society.510 500 60 70 900 380 220 160 280 430 100 370 460 730 310 170 400 70 110 120 80 650 120 1. 2007. and additional data supplied by the American Cancer Society.240 170 550 130 800 3.550 2.150 290 270 70 * 1.500 430 1. numbers are small and NCI and ACS are having difficulty fitting them into the Pickle et al. LEUKEMIA LYMPHOMA MYELOMA page 15 . of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Total** 550 70 740 510 4. 1969-2004.Estimated New Cases of Blood Cancers by Site.550 * * * * *20 * * * * 60 * * * 50 * * * * * * * * * * * * * * * * * * 70 * * 50 * * 60 * * * * 80 * * * * * * * 390 Table 11: Sources: Cancer Facts & Figures 2007.300 110 63.080 600 7. by State.680 920 340 890 170 290 330 190 1.200 350 4. 2007 State Leukemia Non-Hodgkin Lymphoma Myeloma Hodgkin Lymphoma*** Estimated Deaths from Blood Cancers by Site.610 150 2.530 1. Table 12: Sources: Cancer Facts & Figures 2007.410 560 * 740 230 230 930 70 300 50 350 1.160 140 50 360 440 170 320 * 18..880 240 250 50 50 1. which is new for 2007.180 4.160 1.710 570 500 2.
Thus. The SEER (17 region) data cover only about 26 percent of the U. state-by-state data for incidence of Hodgkin lymphoma are not available because these numbers are so small. Definitions Incidence is the number of newly diagnosed cases for a specific cancer or for all cancers combined during a specific time period. This change means that the 2007 incidence estimates are not comparable with previous estimates for determining cancer incidence trends. survival and mortality have been revised. it is the number of new cases per standard unit of population during the time period. population) that belong to the National Program of Cancer Registries. complete prevalence is reported as defined by SEER as “an estimate of the number of persons (or the proportion of population) alive on a specified date who had been diagnosed with the given cancer. When expressed as a rate. CA A Cancer Journal for Clinicians. Relative survival rate is an estimate of the percentage of patients who would be expected to survive the effects of the cancer. Bureau of the Census’ 2000 population data for that region.S. Because of this change in method. Because of changes in the information — such as racial classification — gathered in the 2000 U.S. The description of the methods used was published in Pickle et al. race or sex. so the exact number of cases is not known. Census. may be incomplete in some cases and the data may reflect adjustments that anticipate changes that will occur once the actual data are received. In this report. but these figures do not take into account differences in geography. estimates of cancer incidence. (Observed survival is the actual percentage of patients still alive at some specified time after diagnosis of cancer. population. In some prevalence statistics. These numbers are extrapolated to the entire 17 SEER regions by dividing the number of cancer cases or deaths in a specific region by the U. only the first diagnosed cancer counts. Incidence rates can be calculated based on a number of factors such as age.” as per SEER table I-21. It considers deaths from all causes. Age-adjusted rate is an incidence or mortality rate that has been adjusted to reduce the effects of differences in the age distributions of the populations being compared. based on the “first invasive tumor for each cancer site diagnosed during the previous 29 years (1975-2003). prevalence numbers reported may vary depending upon the method used to determine them. Prevalence may be calculated in a number of different ways. mostly upward. especially in looking at populations in which individuals have had more than one type of cancer. if a person is initially diagnosed with melanoma and later develops leukemia. The data presented in this report are an extrapolation or estimate of the number of cases reported by the 17 Surveillance. The data can be extrapolated for the entire United States by multiplying by the population ratio. This year. cancer or otherwise. no matter how long ago that diagnosis was.S. It includes new (incidence) and preexisting cases and is a function of both past incidence and survival.) Prevalence is the estimated number of people alive on a certain date in a population who previously had a diagnosis of the disease.. LEUKEMIA page 16 LYMPHOMA MYELOMA . This rate is calculated by adjusting the observed survival rate so that the effects of causes of death other than those related to the cancer in question are removed. in comparison to the 2002 SEER report. January/February 2007. The American Cancer Society projects this year’s estimated cancer cases and deaths based on incidence rates for 1995 to 2003 from 41 states (approximately 86 percent of the estimated U. the data presented in the 2007 SEER report placed online on April 15. The specified date is 1/1/2004 for the prevalence estimates. race and ethnicity in various regions and region-specific health risks. the American Cancer Society changed its method of estimating cancer incidence. Because of reporting delays from some of the SEER regions. his or her survival with leukemia may not be counted in leukemia prevalence statistics.S.” We are using the “29-year limited duration” prevalence figures. 2007. in some cases fewer than 17 SEER regions) and death data from the National Center for Health Statistics. Epidemiology and End Results Program (SEER) regions (or. The relative survival rate is a comparison of survival to a person who is free of the disease. Thus.Notes and Definitions Notes The United States does not have a nationwide reporting system or registry for blood cancers. Mortality data reflected in the 2007 SEER report used as a reference reflect data updates from the National Center for Health Statistics from 1975 to 2004.
Ries LAG (eds). 065767. Atlanta: American Cancer Society. Epidemiology. Howe HL.cancer. Bleyer A. Barr R. Edwards BK (eds). National Cancer Institute. 1975-2004. Krapcho M. NIH Pub. MD. In Cancer Epidemiology in Older Adolescents and Young Adults 15 to 29 Years of Age. and End Results (SEER) Program. pp. No. NIH Pub. Epidemiology.” Mattano L Jr.” Hayat MJ. 30-42.gov/csr/1975_2004/ LEUKEMIA LYMPHOMA MYELOMA page 17 . Clegg L. Keller F. Howlander N. Feuer EJ. “Highlights and Challenges.” O’Leary M. 2007. 2007. 174. Barr R. Ward E. Hao Y. 2006. MD.” Bleyer A. 2007. “Cancer Statistics. The Oncologist Vol. Barr R. Shu X-O. 065767. pp.TheOncologist. Mariotto A. O’Leary M. Stock W. Reichman ME. MD. Melbert D. Cheson B. National Cancer Institute. Sheaffer J. Ries LAG.org/cgi/content/full/57/1/30. based on November 2006 SEER data submission. p. Zou Z. http://seer. http://www. 06-5767. “Leukemias. 20-37. Hachey M. Trends. pp. Ries LAG (eds). January. NIH Pub. Including SEER Incidence and Survival: 1975-2000. Barr R. Miller BA.Citations Source Citations Cancer Facts & Figures 2007. “Lymphomas and Reticuloendothelial Neoplasms. “A New Method of Estimating United States and State-Level Cancer Incidence Counts for the Current Calendar Year. Horner MJ. Reichman M. Including SEER Incidence and Survival: 1975-2000. 57. Ross J. 39-51. 2006. Cancer Facts & Figures for African Americans 2007-2008. Including SEER Incidence and Survival: 1975-2000. SEER (Surveillance. http://caonline. Bethesda. In Cancer Epidemiology in Older Adolescents and Young Adults 15 to 29 Years of Age.com/cgi/content/full/12/1/20. O’Leary M. posted to the SEER Web site 2007. 2006. and End Results) Cancer Statistics Review. Howlader N. 2007. Bethesda. Ries LAG (eds). Atlanta: American Cancer Society. No. National Cancer Institute. In Cancer Epidemiology in Older Adolescents and Young Adults 15 to 29 Years of Age. January/February. Edwards BK. No.” Pickle LW. Bethesda. Nachman J. Eisner MP. National Cancer Institute. 25-38. O’Leary M. 12. MD. pp. Feuer EJ. Bleyer A. and Multiple Primary Cancer Analyses from the Surveillance. Jemal A. Bleyer A. Bethesda.amcancersoc. Tiwari RC. CA A Cancer Journal for Clinicians Vol.
Awards up to $200. research reaching a clinical trial can receive $1 million over five years to facilitate new drug discovery or advances in diagnosis or prevention. We offer a wide variety of programs and services in support of our mission: Cure leukemia.000 over three years.6 million annually on research. • Special Fellows are awarded $60.000 over three years. each focused on the discovery of new approaches to benefit patients or those at risk for developing leukemia. Funding for two additional years may be provided for highly promising projects that are entering phase I clinical trial. the Society has awarded more than $550 million in research grants. Thus. The Specialized Center of Research (SCOR) in Leukemia.000 a year for a total of $550. lymphoma and myeloma should be encouraged worldwide.25 million per year over a five-year period. leading to better survival rates and prevention measures for patients. Translational Research and the Specialized Center of Research (SCOR). lymphoma. and improve the quality of life of patients and their families. Career Development Program The Career Development Program supports promising young scientists (Scholars. to a total cost of $6.About the Society The Leukemia & Lymphoma Society is the world’s largest voluntary health organization dedicated to funding blood cancer research and providing education and patient services. leukemia. Since the first funding in 1954. lymphoma and myeloma that is intended to advance treatment. The participating scientists may be at different institutions or from any country. The SCOR program brings together research teams working in complementary areas. 3) Translational Research Program. diagnosis or prevention in the near term.000 over five years. or control of. The SCOR grants also support scientific core laboratories to provide access to innovative technology if required by the participating research programs. lymphoma and myeloma research comprise four review subcomittees. Translational Research Awards are made for an initial three-year period. Translational Research • Scholars in Clinical Research are awarded $110.000. Lymphoma and Myeloma These center grants are awarded to a cluster of at least three research groups that interact to foster advances in the diagnosis. Research grants are awarded in three program areas: Career Development.000 a year for a total of $550. 4) Specialized Center of Research Program that evaluate all grant applications in those programs and determine those applicants with the most innovative and LEUKEMIA page 18 LYMPHOMA MYELOMA . The Grant Review Process Scientists and physician-scientists who are experts in the field of leukemia. lymphoma or myeloma. • Fellows are awarded $50. Hodgkin’s disease and myeloma. 2) CDP-clinical research. the Society’s grant programs are among the most prestigious in the fields of blood cancers.000 a year for a total of $180.000 per year for three years. Research Research Grant Programs The Society’s research programs are based on the belief that all scientifically sound approaches toward a cure for.000 a year for a total of $150. Awards go to those groups that best demonstrate the synergy that will occur from their close interaction. The Society is a nonprofit organization that relies on the generosity of individual and corporate contributions to advance its mission. are granted each year. lymphoma and myeloma. Translational Research Program The Translational Research Program provides early-stage support for research on leukemia. They are: 1) Career Development Program (CDP)-basic research. • Special Fellows in Clinical Research are awarded $60. The program is expected to generate new knowledge and breakthrough discoveries.000 a year for a total of $180. treatment or prevention of leukemia. Each SCOR is funded up to $1.000 over three years. Special Fellows and Fellows) pursuing careers and is stratified into two separately reviewed programs in basic or clinical research: Basic Research • Scholars are awarded $110. for a total of $600. Now supporting $61.000 over five years.25 million.
to 6 p.LLS. You may also chat online with an information specialist.m.org. treatments. These offices conduct lifeenhancing patient services. each group provides information and support.LLS.org or faxing to (914) 949-6691 or contacting the Research Department at (914) 949-5213. Information on registration for these free events can be accessed at www. families. lymphoma. information about our peer-to-peer program First Connection and other programs. The IRC is a worldwide link to information and resources useful to patients. the Society’s programs and services. clinical trials and offer guidance on coping. www. lymphoma. and click “Live Help. They are available to talk one-onone.org. ET. podcasts and Webcast archives of these programs are available at www. A trained patient volunteer currently in remission phones the new patient to share information and support. is held each December on the Friday immediately before the American Society of Hematology meeting.org. This support should advance the understanding.m.org. 2007 the Society will have 379 active grantees at 116 institutions in the United States and abroad. Much of the content of these materials is available to view and download at www. As of June 30.LLS. to 5:00 p. peer counseling and patient financial aid. sponsored by the Society.org/copay. Patients needing assistance may apply on the Society’s Web site. www. The Society’s Web Site The Society’s Web site. audio. The educational program offers varying formats to facilitate the exchange of information and ideas on the newest developments in cancer research and treatment.org. ET. Educational Materials An extensive collection of free educational materials are offered to patients and health professionals.m.important projects to advance the Society’s mission. the Translational Research Grant Progress Review Meeting and the SCOR Progress Review Meeting. www. Co-Pay Assistance Program Patients with AML. and applications for the Society’s three research programs may be obtained by visiting www.m. Professional Education The Society serves the continuing educational needs of the medical and research community through professional symposia offered throughout the year.LLS. Guidelines. The Annual Research Symposium. instructions. from 10:00 a. families and professionals may call the IRC toll free at (800) 955-4572 in addition to corresponding by email at infocenter@LLS. their families and healthcare professionals.org. on the Society’s Web site. LEUKEMIA LYMPHOMA MYELOMA page 19 . the Society distributes more than 1 million booklets. Family Support Group locations. and encourages greater communication among patients.LLS.LLS.” Chapter Programs: Family Support Groups: The Society has developed more than 360 Family Support Groups at 68 chapters. Information specialists are oncology social workers and health educators who provide callers with current information on blood cancers. including support groups. serves a wide variety of education and information needs. Guided by two volunteer oncology health professionals. call (877) LLS-COPAY ( 557-2672) or email copay@LLS. myeloma and MDS who have difficulty paying for or simply cannot afford their health insurance premiums or prescription drug co-pays can now apply for assistance from the Society. lymphoma and myeloma. Patient Services The Society has a network of 68 chapters throughout the United States and Canada. The Society funds several Focused Workshops each year on important topics relevant to hematological malignancies.org. Information Resource Center (IRC) The Society strives to be the world’s foremost source of information on leukemia. Other meetings are held for the Society’s grantees. 9 a. The site features a comprehensive overview of blood cancers. First Connection: This program links newly diagnosed patients to a peer volunteer who has experienced a similar diagnosis. It is continually being updated and expanded to support and promote the Society’s mission. The user has the opportunity to create personalized pages with identified interests.LLS. The Society also hosts numerous teleconferences and Webcasts. Each year. Teleconferences and Webcasts The Society sponsors more than 25 educational teleconferences and Webcasts each year on topics of interest to patients and caregivers. where medical professionals share the latest research findings. Patients. Monday through Friday. brochures and videos through the IRC and local Society chapters. These include the Stohlman Scholar Symposium. myelodysplastic syndromes (MDS) and other blood cancers. friends and healthcare professionals. myeloma. treatment and prevention of leukemia.org or by or emailing researchprograms@LLS.
LLS. emerging therapies and side effects and addresses the unique challenges of nursing management of these patients. that program has funded some $30 million in additional blood cancer research. CML Issues and Insights: A Nursing Education Program on Chronic Myelogenous Leukemia. patients and school personnel to assure youngsters a smooth transition from active treatment back to school.and long-term effects that children may experience after treatment. The Path to Progress: Clinical Trials in Blood Cancers: This program provides patients. Advocacy Since 1994.org and is being sponsored by a generous. local volunteers and staff are building a grassroots advocates’ network to rally patients and their families to promote common goals related to cancer research and treatment. Printed literature. this education program discusses possible emotional and cognitive short. To date. families and healthcare professionals with a clear description of what clinical trials are. It is supported by Amgen Oncology. Through the Patient Financial Aid Program. Society volunteers and staff visit Capitol Hill regularly to lobby Congress in support of issues that impact research and patient care. Accessing the Best Cancer Treatment at Any Age: This education program presents an overview of the many factors (not age alone) that healthcare professionals should assess to determine an appropriate cancer treatment plan for an older adult. how cancer drugs are developed and what the emerging treatment options are for leukemia. In 2001. parents. The patient education program was funded at $18 million through 2007.Patient Financial Aid Program: For more than 31 years. The Society has identified key issues that currently shape its advocacy agenda.000 and has become a potent voice in public policy deliberations. The Trish Greene Back to School Program for Children with Cancer: This program is designed to increase communication among healthcare professionals. This nursing education program provides an overview of CML. diagnosis. Working through chapters across the country. including • Insurance coverage of patient-care costs in clinical trials • Ready access by all Americans to quality cancer care • Increased funding for the National Institutes of Health and National Cancer Institute (NCI) • Increased funding for blood cancer research at other federal institutions • Federal funding for patient education and support programs. the Society has successfully ensured coverage of routine care in cancer clinical trials in three states and secured additional funding for patient support programs in four others. the Society successfully lobbied Congress for legislation that authorizes a new blood cancer research effort at the NCI and creates a new blood cancer education program for patients and the public under the Centers for Disease Control and Prevention. LEUKEMIA page 20 LYMPHOMA MYELOMA . unrestricted educational grant from Genentech BioOncology and Biogen Idec Inc. Welcome Back: Facilitating the Return to School for Children with Cancer: A new addition to The Trish Greene Back to School Program. DC. providing additional support for blood cancer patients and their families nationwide. Meet the Expert on Non-Hodgkin Lymphoma: This program presents basic information on terminology. treatments. On the state level. lymphoma and myeloma. This program is being sponsored by an unrestricted education grant from Novartis Oncology. the Society’s advocacy program has been a strong voice in Washington. staging and classification of nonHodgkin lymphoma (NHL). That network now numbers more than 35. This program is also accessible as a Webcast at www. reimbursement of up to $500 per year helps cover the costs of transportation.S. risk factors. Patient financial aid funds are subject to availability. videos and other materials to aid the process are available through all local chapters. the Society successfully lobbied Congress to institute a blood cancer research initiative as part of the U. drugs and various treatments not covered by insurance. and offers numerous resources that can assist childhood cancer survivors to flourish in the school environment posttreatment. treatments and future directions for NHL are also discussed. New Directions in Myeloma Therapy: This program presents an overview of myeloma. This Society program is being supported by Celgene Corporation and Millennium Pharmaceuticals. In 2002. This program is made possible by the Lance Armstrong Foundation. New insights. This program is provided through an unrestricted educational grant from Millennium Pharmaceuticals. emerging therapies and managing side effects and how to find emotional support when living with the illness. representing to policy makers at all levels of government the healthcare quality concerns and medical research interests of patients and their families. treatments. Department of Defense’s medical research program. the Society has helped patients demonstrating a need for financial assistance cover a portion of their treatment costs.
and Rebecca Siegel. provided statistical assistance. NCI. for compilation of data for this publication. The Leukemia & Lymphoma Society extends special thanks to Myrna Watanabe. of the American Cancer Society (ACS). Milton Eisner of SEER.seer. with the understanding that the Society is not engaged in rendering medical or other professional services.cancer. It is distributed as a public service by The Leukemia & Lymphoma Society Inc. .. This publication is designed to provide information in regard to the subject matter covered. provided ACS’s state-by-state statistics on myeloma and Hodgkin lymphoma.Acknowledgements Additional data from SEER*Stat Databases at http://www.D. Ph.gov.
4572 www. PS80 35M 6/07 .LLS.LLS Information Resource Center (IRC): 800. Hodgkin’s disease and myeloma. and improve the quality of life of patients and their families.Home Office 1311 Mamaroneck Avenue.HELP. New York 10605 Tel: 888. The Society is a nonprofit organization that relies on the generosity of individual. lymphoma. corporate and foundation contributions to advance its mission. Suite 310 White Plains.org Our mission: Cure leukemia.955.
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