This action might not be possible to undo. Are you sure you want to continue?
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.
Leukemia. This year.266 people living today with lymphoma.953 either have or are in remission from non-Hodgkin lymphoma (NHL). 19. Highlights from the Report Include: New Cases • An estimated 135. in April 2007. *Myeloma Biology and Management. the likelihood of dying from most leukemias*.520 people in the United States will be diagnosed with leukemia.424 people living today with myeloma. Five-Year Relative Survival Rates 1960-1963 vs. 138.4 percent of the 1. • New cases of leukemia. • Non-Hodgkin lymphoma is the fifth most common cancer in the United States.1975-1977 vs. 71. 1996. an annual publication. • In 2007.730 people will die from lymphoma (1. which becomes malignant and multiplies continuously. Mortality from the disease increased 24 percent. someone is diagnosed with a blood cancer. *except acute myelogenous leukemia (AML) and other.cancer. National Cancer Institute. • Leukemia causes more deaths than any other cancer among children and young adults under the age of 20.650 total cancer-related deaths. 21.790 people will die of leukemia. and its age-adjusted incidence rose by nearly 84 percent from 1975 to 2004. the National Cancer Institute’s Surveillance. lymphoma and myeloma will cause the deaths of an estimated 52. and myeloma. This abnormal accumulation interferes with the production of healthy blood cells.Executive Summary Facts 2007-2008.070 from Hodgkin. the incidence of myeloma increased 8 percent. nonacute myelogenous and monocytic leukemias Lymphoma: • There are 544. 1975-2004. 63.349 Americans are living with leukemia. This year. www. 10. • Every five minutes. • These blood cancers will account for 9. Cancer Statistics Review 1975-2004 (see Notes. • Thirty-two percent more males are living with leukemia than females. The data within Facts 2007-2008 reflect the most recent statistics available from SEER.3 percent of the deaths from cancer in 2007 based on the 559. More males are diagnosed with leukemia and more males die of it than females. lymphoma and myeloma. 2007 and SEER 19731993.313 either have or are in remission from Hodgkin lymphoma. 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. lymphoma and myeloma in 2007. • In general. National Cancer Institute.310 people in the United States this year. Epidemiology and End Results) Cancer Statistics Review.240 people will be diagnosed with leukemia. lymphoma and myeloma decreased from 1995 to 2004 (the last year data were available). Deaths • Leukemia.659 people in the United States who are either living with or are in remission from leukemia.790 people will die from myeloma. someone dies from a blood cancer. page 16). • In 2007. This statistic represents 143 people each day.gov. 2nd Edition. Oxford University Press.190 cases of Hodgkin. 1998. 44.seer. 405.190 cases of non-Hodgkin). LEUKEMIA LYMPHOMA MYELOMA page 1 . Hodgkin and non-Hodgkin lymphoma and myeloma will account for nearly 9. • This year. Hodgkin and non-Hodgkin lymphoma. • Every 10 minutes. From 1975 to 2004. 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.660 from non-Hodgkin). 19. is a compilation of the most recent data on leukemia. or nearly six people every hour. Survival • An estimated 823. Epidemiology and End Results Program. 1960-1963 1975-1977 1996-2003 Figure 1: Sources: SEER (Surveillance.900 people will be diagnosed with myeloma. • Eighty-six percent of myeloma cases occur in people aged 55 and over. The next SEER Cancer Statistics Review is expected to be published online in April 2008. 18. These data were published online by SEER.444. Myeloma: • • • • There are 60.920 new cancer cases diagnosed in the United States this year.380 new cases of lymphoma will be diagnosed in the United States (8.
especially for children. Autologous transplantation uses the patient’s own marrow stem cells and is technically not transplantation since another person is not the donor. decreased ability to fight infections and a predisposition to bleeding. which becomes abnormal (malignant) and multiplies continuously. Such an approach would greatly lessen the proportion of children without a donor. Research is being conducted to improve socalled “haploidentical” transplant. Patients with leukemia. (Numbers do not add up to 100% because of rounding. The numbers of stem cells in cord blood are often insufficient for the needs Figure 2: Source: Cancer Facts & Figures. Patients with acute lymphocytic leukemia (ALL). lymphoma and myeloma. 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. some types of Hodgkin lymphoma. An allogeneic transplant uses blood or marrow stem cells from a normal donor. usually in combinations of two or more drugs. myeloma and lymphoma are usually treated with chemotherapy.About the Diseases Leukemia. 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. The technique of harvesting stem cells from blood and cord blood has made transplantation available for more LEUKEMIA page 2 LYMPHOMA MYELOMA . In special instances. The harvesting. freezing and storing of cord blood have provided another source of stem cells for transplantation. a search of the National Marrow Donor Program registry of tissue-typed volunteers could be made for a matched unrelated donor. Syngeneic transplant describes the use of an identical twin as donor. The accumulation of malignant cells interferes with the body’s production of normal blood or immune cells and can result in severe anemia. 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. However. 2007. especially in young children. Estimated New Cases (%) of Blood Cancers in 2007 Myeloma 15% Leukemia 33% Lymphoma 53% Treatment Chemotherapy and Radiotherapy: The use of chemotherapy (anticancer drugs). The technique is important. slightly mismatched cord stem cell donors may be used quite successfully. If a sibling is not available. Hodgkin and non-Hodgkin lymphoma and myeloma are cancers that originate in a cell in the bone marrow or lymphatic tissues. 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. American Cancer Society. for which a parent rather than a sibling could be the donor. 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. Stem cells also circulate in large numbers in fetal blood and can be recovered from umbilical cord and placental blood after childbirth. studies suggest that two matched cord donors may result in a higher success rate in larger adults. 2007. 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. is largely responsible for the dramatic improvement in managing leukemia and lymphoma. Approximately 50 different drugs are now being used in the treatment of these diseases.) of larger adult patients. There are two major types of stem cell transplants: syngeneic and allogeneic. 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.
Coordination between specialists and primary care physicians is essential to provide the best care possible. the donor’s cells take hold and the patient’s leukemia. Biomarkers could be high levels of certain substances in the body such as antibodies or hormones. lymphoma or myeloma is attacked and suppressed by donor lymphocytes that form from the donor stem cells. few severe adverse effects on normal tissues and a very high response rate. 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. two second-generation agents. Imatinib mesylate (Gleevec®) is now the drug of choice in newly diagnosed patients with chronic myelogenous leukemia (CML). Some treatment centers have follow-up clinics that provide a comprehensive. Identifying these biomarkers will allow researchers to develop tests that can predict what effects an individual is at risk of developing.org/). “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. The protein is an enzyme in the family of tyrosine kinases. In standard stem cell transplantation. In nonablative transplantation. “Ablation” referred to wipingout the recipient’s cancer. It works by blocking the oncogeneencoded protein product that instigates the transformation to a leukemic cell. Development of New Drugs: In the past decade. Because blood. New Approaches to Treatment Several areas of research have resulted in new approaches to the treatment of leukemia. Cancer survivors should have physical examinations yearly or more often. and Young Adult LEUKEMIA LYMPHOMA MYELOMA page 3 . lymphoma or myeloma can have an allogeneic transplant. This still experimental approach greatly lessens the early toxicity of transplantation and has extended the age at which recipients with leukemia. marrow and immune system. thereby allowing doctors to plan treatment accordingly. Cancers (http://www.patients. donors of blood stem cells require special treatment to mobilize sufficient stem cells from marrow into their blood before cells are harvested. Regular examinations may include screening for cancer recurrence or the development of secondary cancer or other late effects of treatment. 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. identify recurrence of the disease and detect long-term or late effects. the recipient’s blood cell and immune system are preserved. Adolescent. Over time. as well as marrow. multi-disciplinary approach to monitoring and supporting cancer survivors. making the procedure more tolerable. 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. 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. This “graft versus leukemia or lymphoma effect” can suppress (cure) the malignancy and is a prolonged (indefinite) form of immunotherapy. is a source of stem cells for transplantation. Most follow-up clinics specialize in pediatric cancer survivors. To ensure there will be enough blood stem cells for successful transplantation. Although a minority of patients have developed resistance to the drug. lymphoma and myeloma. ablation of the recipient’s blood-cell forming and immune cells was the price that had to be paid to eradicate the leukemia. but some follow adult cancer survivors. as needed. Follow-Up Care Regular medical follow-up enables doctors to assess the full effect of therapy. Cancer survivors should see their primary care physicians for general health examinations and an oncologist for follow-up care related to cancer. or genetic factors that can increase susceptibility to certain effects. decreased side effects. Follow-Up Guidelines: The Children’s Oncology Group has established Long-Term Follow-Up Guidelines for Survivors of Childhood. several important new drugs and new uses for existing drugs have greatly improved cure rates or remission duration for some patients with leukemia. 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. Stem cells not only reside in the marrow but also circulate in the blood.childrensoncologygroup. these cells can be harvested from the blood of a donor. frozen and stored and later transplanted in the patient. Blood and cord blood transplants differ from marrow transplants principally in the source of the cells collected for transplant.
approved by the FDA for all types of MDS. Arsenic trioxide also adds to the drugs available to treat this subtype of acute leukemia. thus rituximab is an anti-CD20 antibody. principally. thalidomide (Thalomid®). a less common type of chronic lymphocytic leukemia (CLL). farnesyl transferase inhibitors and reduced-intensity stem cell transplantation. 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). In patients with anemia. Monoclonal antibodies have added to the arsenal of agents that are used for the treatment of patients with lymphoma and leukemia. immune cell administration and vaccine development. Food and Drug Administration [FDA] in 2006) and nilotinib (in clinical trials). 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. It is especially active against the lymphocytes in CLL. 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. Azacitidine (Vidaza®). perhaps 20 percent of cases also derive benefit. and enhances the specificity of treatment to minimize toxic effects on normal tissues. cyclophosphamide. in combination with dexamethasone. Early studies indicate the combination of arsenic trioxide and all-trans retinoic acid may be a further advance in the initiation of therapy. has improved dramatically with the introduction of cladribine. however. chronic eosinophilic leukemia (formerly hypereosinophilic syndrome).dasatinib (Sprycel®)(approved by the U. 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. Cell surface antigens have been given a cluster designation (CD) followed by a number. doxorubicin (Adriamycin®). such as follicular lymphoma. Three types of immunotherapy are being explored: antibody treatment. Lenalidomide (Revlimid®). 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. Velcade is approved by the FDA for treating people with myeloma who have had at least one prior therapy. reducing the need for transfusions in some patients. PDGFR or KIT oncoproteins). are entering clinical use and can overcome this resistance in some cases. The treatment of hairy cell leukemia. Other therapies in clinical research to treat MDS include arsenic trixoxide. although initially used in indolent lymphomas. Patients with more severe forms of MDS are very unlikely to respond to the agent. Cladribine induces long-term remissions in nearly 90 percent of patients treated at diagnosis for one week. LEUKEMIA page 4 LYMPHOMA MYELOMA . Clofarabine (Clolar®). 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. Rituximab has become an important agent to treat CD20-positive lymphocytic malignancies.S. Gleevec is not only a very important new agent in the treatment of CML. Some patients with moderately severe. Alemtuzumab (Campath®) is a monoclonal antibody directed against the antigen CD52 found on T and B lymphocytes. This drug is also being tested in clinical trials to treat adult acute leukemia and MDS. Rituximab is an antibody directed at the target CD20 antigen on B-cell lymphoma cells. vincristine (Oncovin®) and prednisone–therapy for diffuse large B-cell lymphoma. but it can also induce remissions in some cases of acute leukemia. approved by the FDA in 2005. kill unhealthy bone marrow cells and may help the bone marrow function more normally in MDS patients. a thalidomide derivative. Monoclonal Antibody Therapy: Monoclonal antibodies are laboratory-produced proteins that can be infused into an appropriate patient. Indeed. the most prevalent lymphoma subtype. and Decitabine (Dacogen®). lymphoma or myeloma. 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. 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®). In May 2006. was approved by the FDA for newly diagnosed myeloma. but without this specific chromosome 5 abnormality. symptomatic anemia have improvement in hemoglobin levels with this agent. Pentostatin is another effective drug that can be used in patients with hairy cell leukemia who do not respond to cladribine. it has now become an important fifth drug in the R-CHOP–rituximab.
These are called conjugated monoclonal antibodies. myeloma and leukemia. 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. less responsive to therapy. In one approach. lymphoma and myeloma. the patient’s immune cells would be treated in the laboratory to train them to attack the residual leukemia. Monoclonal antibodies can also be linked to a radioactive isotope to target and kill specific cancer cells. or become. These drugs have been approved to treat relapsed B-cell non-Hodgkin lymphoma. Approaches to reversing multidrug resistance are under study. Many cancer treatment vaccines under development are intended to induce antigen-specific antitumor immune responses. In another approach. 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. the infusion of the original marrow donor’s lymphocytes can re-induce remission. The goal is to extend the duration of remission achieved by remissioninduction therapy of various types. b) a modality that uses molecules of RNA to silence complementary (DNA) genes. Studies of vaccines used in patients with follicular or indolent lymphoma have demonstrated an immune response. 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. Vaccines are in clinical trials for types of acute and chronic leukemia. DNA vaccines that contain the DNA that encodes the specific antigen are being tested. cells are isolated in the laboratory and start making antibodies after insertion of the cancer antigen. They deliver the toxic substance directly to the cancer cells. and aptamer treatment. In some approaches. 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. LEUKEMIA LYMPHOMA MYELOMA page 5 . some vaccines are made from leukemic cells treated in test tubes to convert them to potent antigen-presenting cells. This drug. is approved for older patients with AML who relapse after initial treatment. 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. Paradoxically. 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. gemtuzumab (Mylotarg®). gene therapy researchers are trying to modify an oncogene (BCR-ABL) that produces a protein that stimulates malignant cell growth. a technique that prepares small molecules in the laboratory that have the ability to inactivate proteins that cause disease. This means that the vaccine induces an immune response against the cancer cells present in the patient. In patients with CML who have relapsed after stem cell transplantation. These cells are. new forms of cancer therapy may be developed. Examples of this treatment are the drugs ibritumomab (Zevalin®) and tositumomab and iodine I131 tositumomab (Bexxar®). If the gene in the former case is an oncogene or the protein in the latter case is an oncoprotein. In studies of CML. Reversal of Multidrug Resistance: The malignant cells of patients have mechanisms that may allow them to escape the damaging effects of chemotherapy agents. Vaccines: Experimental treatment vaccines are now being studied to treat certain types of lymphoma. An alternative strategy called molecular targeted drug development targets the oncoprotein. lymphoma or myeloma cells. These types of vaccines would be used in patients who have small amounts of residual blood cancer after chemotherapy or stem cell transplantation. 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. Two new and potentially important approaches include a) the application of RNA interference. 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. In each case.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.
4 percent of leukemias in children aged 0-19 are CML. red blood cells and white blood cells.579 21. National Cancer Institute.150 24.659 people in the United States are living with leukemia.440 Table 2: Sources: SEER (Surveillance. Surveillance Research Program.720 44. It is characterized by the uncontrolled accumulation of blood cells.000 population.790).189 27. and End Results) Cancer Statistics Review 1975-2004. based on the November 2006 SEER data submission. Table 3: Source: Cancer Facts & Figures 2007. functionless cells in the marrow and blood. A shortage of platelets results in bruising and easy bleeding. develops in virtually all leukemia patients.240 Male 3.380 6.501 50. Only 2. and SEER Program. Nearly 54 percent of the new cases of this disease will occur among children in 2007 (about 2. 2007. • The most common form of leukemia in children is acute lymphocytic leukemia (ALL). Acute leukemia is a rapidly progressing disease that results in the accumulation of immature.S. The four major types of leukemia are shown in Table 1.800 Female 2. American Cancer Society. NCI. Incidence by Gender Incidence rates* for all types of leukemia are higher among males than among females.200 15.340 13. more than half of all cases occur after age 67.800 children.570 19.240 new cases of leukemia will be diagnosed in the United States this year. 2007. LEUKEMIA page 6 LYMPHOMA MYELOMA .440 adults compared with 3. Anemia.960 7. In 2007. DCCPS. Chronic leukemias account for 7 percent more of the cases than acute leukemias. Leukemia is expected to strike more than 10 times as many adults as children in 2007. released April 2007. New Cases An estimated 44. The marrow often no longer produces enough normal platelets. males are expected to account for 56 percent of the new cases of leukemia. each of which can be acute or chronic. The terms myelogenous or lymphocytic denote the cell type involved. Estimated 29-Year L-D Prevalence Counts on 1/1/2004 by Duration. Chronic leukemia progresses more slowly and allows greater numbers of more mature.S. The lack of normal white cells impairs the body’s ability to fight infections.060 2.570 5. Epidemiology. a deficiency of red cells. • About 33 percent of cancers in children aged 0-14 years are leukemia • Most cases of chronic myelogenous leukemia (CML) occur in adults.570 3. Leukemia is divided into four categories: myelogenous or lymphocytic.350 2.140 6. (About 40. functional cells to be made. The incidence rates are usually presented as a specific number per 100. Prevalence of the Four Major Leukemias as of Jan.060 8. • Most cases of leukemia occur in older adults.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. 1.000 2. Statistical Research and Applications Branch.410 4.Leukemia Leukemia is a malignant disease (cancer) of the bone marrow and blood.) • The most common types of leukemia in adults are acute myelogenous leukemia (AML) and chronic lymphocytic leukemia (CLL). *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. aged 0-19. Prevalence database: U. 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. Approximate U. 2004 Type Chronic lymphocytic leukemia Chronic myelogenous leukemia Acute lymphocytic leukemia Acute myelogenous leukemia Prevalence* 95. *Note: Incidence rates are the number of new cases in a given year not counting the preexisting cases.
CLL incidence increases dramatically among people who are aged 50 and older.922 cases per year. Figure 3: Source: Cancer Facts & Figures 2007. there were 4.to 19-year olds. ALL incidence was approximately twice that of AML. From 1975 to 2000. These signs are not specific to leukemia and may be caused by other disorders. eighth and ninth decades of life. The incidence rate for all cancers among AfricanAmericans in the Seer (17 region). In the 17 SEER regions of the United States. Leukemia rates are substantially higher for Hispanic.799 children under the age of 20 diagnosed with leukemia from 2001-2004. In 25. Some people with chronic leukemia may not have major symptoms and are diagnosed during a medical examination. Incidence by Age-Group Incidence rates by age differ for each of the leukemias. However.Estimated Proportion of New Cases (%) in 2007 for Each Type of Leukemia Including Adults and Children 3. The diagnosis of leukemia requires specific blood tests. averaging about 189. About 2. was 504 per 100. AML incidence was approximately 1. The American Cancer Society estimates that there will be approximately 152. American Indian/Alaskan natives. neither explains most cases. 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. Among 15. Hispanic children of all races under the age of 20 have the highest rates of leukemia. including the examination of the cells in blood or marrow. Children. 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.to 29-year olds. from 2000-2004. LEUKEMIA LYMPHOMA MYELOMA page 7 . and AML incidence increases dramatically in people who are aged 60 and older.to 4-year-old children is more than nine times greater than the rate for young adults ages 20 to 24. white and Asian/Pacific islander children than for black children. 2007. The leukemias represented 27 percent of all cancers occurring among children younger than 20 years from 2000-2004.5 times that of ALL. Adolescents and Young Adults.900 new cases of cancer diagnosed in African-Americans in 2007.619 with ALL. 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 strikes all ages and both sexes. Adults.790 new cases of childhood ALL are expected to occur in 2007. The cause of leukemia is not known. Possible Causes of Leukemia Anyone can get leukemia. The incidence of ALL among 1. including 3. Leukemia is one of the top 15 most frequently occurring cancers in minority groups. Leukemia incidence is highest among whites and lowest among American Indians/Alaskan natives. It is estimated that in 2007. American Cancer Society. Most children under 15 years of age with ALL are cured. The most common form of leukemia among children under 20 years of age is ALL. They do warrant medical evaluation.000 population. CML incidence also increases dramatically among people who are aged 60 and older. the incidence of AML slowly rose while that of ALL steadily decreased in the period from late adolescence to older adulthood. Although chronic exposure to benzene in the workplace and exposure to extraordinary doses of irradiation can be causes of the disease.800 children will be diagnosed with leukemia throughout the United States. leukemia rates are higher in Americans of European descent than among those of African descent. These cancers are most prevalent in the seventh.
6 10-14 0.1 for children under 15 • CML: 44.7 7 5 3 1 0 1. Complete remission means that there is no evidence of the disease and the patient returns to good health with normal blood and marrow cells. The relative survival rates differ by age of the patient at diagnosis. In 1960-1963. By 1975-1977.4 percent for children under 5 • CLL: 74. Relapse indicates return of the cancer cells and the return of other signs and symptoms of the disease. a patient had a 14 percent chance of living five years. LEUKEMIA page 8 LYMPHOMA MYELOMA . 2007.5 21.9 25-29 1. During 1996-2003. the overall relative survival rate was nearly 50 percent.4 percent Five-Year Relative Survival Rates for All Ages.1 Incidence (per 100. when compared to a person without leukemia.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. 90. National Cancer Institute.8 1-4 0. Thirty-two percent more males than females are living with leukemia. 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. Epidemiology and End Results) Cancer Statistics Review 1975-2004. 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. race and type of leukemia. 54. Treatment of Leukemia The aim of treatment is to bring about a complete remission.4 5-9 0.2 15 13 11 9 7.3 1.1 4.2 1.9 20-24 0. Epidemiology and End Results) Cancer Statistics Review 1975-2004.2 23 21 19 19. 2007. and in 1996-2003. the five-year relative survival rate had jumped to 35 percent. Treatment centers report increasing numbers of patients with leukemia who are in complete remission at least five years after diagnosis of their disease.6 2. a complete remission (no evidence of disease in the blood or marrow) that lasts five years after treatment often indicates cure.3 percent overall. gender. 2000-2004 25 23.4 <1 0. All Types Leukemia. National Cancer Institute. The five-year relative survival rate has more than tripled in the past 47 years for patients with leukemia.7 percent overall.000) 17 15.9 15-19 0.Age-Specific Incidence Rates for Acute Myelogenous Leukemia (All Races). the five-year relative survival rates overall were: • ALL: 65.2 10. For acute leukemia.3 3.8 percent • AML: 20.
940 3.320 Female 600 1. In 2007. In 2007.680 12. There will be an estimated 4.990 490 6. 1975-2004. Implications of long-term survivals in acute stem cell leukemia of childhood treated with composite cyclic therapy.500 deaths from CLL and 1.470 females. Despite this decline.Five-Year Relative Survival Rates for Acute Lymphocytic Leukemia. in Children Under 15 Years of Age.390 additional deaths.390 21. Non-Hispanic whites diagnosed with leukemia over the age of 44 had the highest death rates during this period. 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. deaths from leukemia are expected to be distributed in the following numbers: In 2007.420 4. leukemia causes more deaths than any other cancer among children and young adults under age 20. 1964:24:477-494. Zuelzer WW. 2007. 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.500 8. 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.420 deaths from ALL. unclassified forms of leukemia Total Overall 1. leukemia will be the fifth most common cause of cancer deaths in men and the sixth most common in women.790 deaths in the United States will be attributed to leukemia in 2007: 12. American Cancer Society. Unclassified forms of leukemia will account for 6. Blood. Hispanics with leukemia who are under the age of 25 had the highest mortality rates from the disease between 1990 and 1999. LEUKEMIA LYMPHOMA MYELOMA page 9 .990 deaths from AML and 490 deaths from CML.790 Male 820 2. about 515 children under the age of 14 are expected to die from leukemia. 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. There will be an estimated 8. Sources: 1.560 5. SEER (Surveillance. National Cancer Institute. 2007.470 Table 4: Source: Cancer Facts & Figures 2007. 2.710 9. Cancer Statistics Review.320 males and 9.020 240 3. Epidemiology and End Results). Deaths It is anticipated that approximately 21. 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.970 250 2.
malignant cell found in Hodgkin lymphoma tissues). 2007.710 Total 8.190 71. Persons infected with the human immunodeficiency virus (HIV) have a much higher risk of developing lymphoma. 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. The bacterium Helicobacter pylori is associated with the development of lymphoma in the stomach wall. The Epstein-Barr virus causes Burkitt’s lymphoma in Africa.000 for females.720 28. LEUKEMIA page 10 LYMPHOMA MYELOMA . Lymphoma results when a lymphocyte (a type of white blood cell) undergoes a malignant change and begins to multiply. New Cases of Lymphoma by Gender. Hodgkin Lymphoma Hodgkin lymphoma is a specialized form of lymphoma and will represent about 11. incidence rates for non. an average annual percentage increase of 2. 2007 Type Hodgkin lymphoma Non-Hodgkin lymphoma Total Male 4.3 per 100. Each histologic grouping is diagnosed and treated differently.Hodgkin lymphoma are higher in Americans of European descent than among those of African descent. including the presence of an abnormal cell called the ReedSternberg cell (a large. Hodgkin lymphoma has characteristics that distinguish it from all other cancers of the lymphatic system.S. in general whites have higher incidence rates than blacks. New Cases About 71.200 38. The reasons for the development of non-Hodgkin lymphoma are not certain.000 for females.9 per 100. there are 138.990 32.000 at ages 20 to 24 for males and 1. and each has prognostic factors that categorize it as more or less favorable. Both Hodgkin and non-Hodgkin lymphomas are more common in males than in females. intermediate and high grade.670 Female 3. In 2004. 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. Incidence rates for Hodgkin lymphoma tend to be higher among males than among females. The incidence of Hodgkin lymphoma is consistently lower than that of non-Hodgkin lymphoma. Living with Lymphoma In the United States in 2007. The groups are often classified as indolent or aggressive.470 34.5 percent of all lymphomas diagnosed in 2007. the difference was small.266 members of the U.190 63. population who are living with lymphoma. they are 52.Lymphoma Lymphoma is a general term for a group of cancers that originates in the lymphatic system. Non-Hodgkin lymphoma is the fifth most common cancer in males and females in the United States.6 per 100. Immune suppression plays a role in some patients. Incidence by Gender Table 5 illustrates the breakdown of incidence of lymphoma by gender.190 cases of Hodgkin lymphoma and 63.313 people living with Hodgkin lymphoma (active disease or in remission) and 405.380 Americans will be diagnosed with lymphoma in 2007 (8.8 percent.000 for males and 38.9 per 100.380 Table 5: Source: Cancer Facts & Figures 2007. These risk factors explain only a small proportion of cases. It is the sixth most common cause of cancer deaths in males and in females. By ages 60 to 64. Fifty-three percent of the blood cancers diagnosed are lymphomas. Age-specific incidence rates of non-Hodgkin lymphoma are 2. More than four percent of all cases of Hodgkin lymphoma diagnosed in 2007 will be in children under 15 years of age.953 people living with nonHodgkin lymphoma for a total of 544. while 0. American Cancer Society.190 cases of non-Hodgkin lymphoma). rose by 84 percent from 1975 to 2004. or low.7 percent of all cases of non-Hodgkin lymphoma will be diagnosed in children under 15 years of age this year. After 50 to 54 years of age. eventually crowding out healthy cells and creating tumors that enlarge the lymph nodes or other sites in the body.
Adolescents are more commonly diagnosed with Hodgkin lymphoma than young children. Non-Hodgkin lymphoma is the ninth most common cause of cancer death in males and the seventh in females in the United States. Hodgkin lymphoma incidence rates are higher in adolescents and young adults than in adults in their middle years. Signs and Symptoms Signs and symptoms of Hodgkin lymphoma include painless swelling of lymph nodes in the neck. The most common early sign of other forms of lymphoma is also painless swelling of the lymph nodes – usually in the neck. the highest incidence of non-Hodgkin lymphoma is in Asian/Pacific islanders. the highest incidence of non-Hodgkin lymphoma is in non-Hispanic whites.1 cases per 100. chemotherapy or both may result in cures for most patients with Hodgkin lymphoma.070 from Hodgkin lymphoma).5 percent) are the third most common cancers in children. troublesome itching and weight loss. This represents a significant improvement in the rate of recovery. indigestion and abdominal pain. sweating at night.000 by ages 60 to 64. cell type and location of the lymphoma. In children from 0 to 19 years of age.5 percent. Incidence in Children The incidence of Hodgkin lymphoma among people under 20 years of age was 1. The five-year relative survival rate for non-Hodgkin lymphoma patients has risen from 31 percent in whites in 1960-1963 to 63.8 percent) and neoplasms of the brain and other nervous tissue (17.000 persons at ages 80 to 84. and non-Hodgkin lymphoma. five-year relative survival for non-Hodgkin lymphoma is now 83. 4. Survival for Adults Hodgkin lymphoma is now considered to be one of the most curable forms of cancer. The incidence in this group decreased almost steadily and significantly between 1975 and 1999. about 10. most children with nonHodgkin lymphoma did not live five years after diagnosis. night sweats. recurrent high fever.8 percent for all races in 1996-2003. From ages 15 to 19. loss of appetite and bone pain. and more than 46-fold to 112. and is the eighth most common cause of cancer death in that group. Early stage. It has remained fairly constant since 1999. persistent fatigue.400 children under the age of 15 will be diagnosed with cancer in 2007. excessive tiredness. localized non-Hodgkin lymphoma is sometimes treated with radiation. 3. In children under 20 years of age.0/1 million population). Treatment for non-Hodgkin lymphoma sometimes includes vaccines and other forms of immunotherapy. The rate increases more than 18 times to 45. Five-year relative survival is now 95 percent for Hodgkin lymphoma in children aged 0 to 14 years.5/1 million population). Death rates have been declining for Hodgkin lymphoma patients since the mid-1970s. widespread disease requires chemotherapy or chemotherapy and/or monoclonal antibody therapy with radiation. armpit or groin.5 percent.Among women.1 per 100. Even in the mid-1970s. groin or in the abdomen.to 24year-old individuals. Survival for Children Five-year relative survival is 95. It is rarest among American Indian/ Alaskan native children. Lymphomas (Hodgkin lymphoma. About 2. followed closely by Hispanic children of all races (24. Symptoms also often include fever. 1.4 cases per 100. depending on the tumor size. Non-Hodgkin lymphoma is the fifth most common cancer in Hispanics. In children up to age 14 years. Deaths An estimated 19. armpit. comprising nearly 5 percent of all cancers diagnosed.1 cases per 100. Treatment Hodgkin lymphoma is often treated with radiation and chemotherapy.730 persons will die from lymphoma in the United States in 2007 (18. Radiation. In the United States.000 children in 2004. 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. LEUKEMIA LYMPHOMA MYELOMA page 11 .2 percent for Hodgkin lymphoma in people under 20 years of age. following leukemia (26. lymphomas are most commonly diagnosed in whites (24. Hispanics of all races have the second highest incidence rates of non-Hodgkin lymphoma after whites.660 from non-Hodgkin lymphoma. Incidence in Adults The incidence of non-Hodgkin lymphoma increases with age.9 percent).000 people occur in 20.
4 2.1 102. 2007.4 2.9 1.4 80.8 4.9 7. National Cancer Institute.660 19. *<16 cases per time interval.8 2.600 10.070 18.8 3. 2000-2004 110 100 90 80 Incidence (per 100. 2007.0 3.000) 70 60 50 40 30 22.4 2.2 1.2 4. National Cancer Institute.4 15.3 <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.1 0.6 32. 2007.730 Male 770 9. Table 6: Source: SEER (Surveillance.1 63.9 3.0 1.0 0.6 0. LEUKEMIA page 12 LYMPHOMA MYELOMA .3 4.9 4. 2007.0 20 10 0 0.1 3.1 3.060 9.0 2.0 45.4 2.8 112.370 Female 300 9.360 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. National Cancer Institute. 2000-2004 6 Incidence (per 100. Epidemiology and End Results) Cancer Statistics Review 1975-2004.4 3.000) 5 4 3 2 1 0 0. 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.Age-Specific Incidence Rates for Hodgkin Lymphoma. Age-Specific Incidence Rates for Non-Hodgkin Lymphoma. Epidemiology and End Results) Cancer Statistics Review 1975-2004.5 10.1 0.5 <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. Epidemiology and End Results) Cancer Statistics Review 1975-2004.0 100.1 4. * <16 cases for time interval. American Cancer Society.
000). Malignant plasma cells produce an abnormal protein called monoclonal immunoglobulin. LEUKEMIA LYMPHOMA MYELOMA page 13 .1 21.S. myeloma was the 10th most commonly diagnosed cancer among African-American men and women. Usually. Living with Myeloma An estimated 60. • The median age at diagnosis for African-Americans is 67. 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. Age-Specific Incidence Rates for Myeloma. has been increasing.960 men and 8. At times. especially. 1-4. tire more easily and feel weak. Approximately 3 percent of all cancer-related deaths among AfricanAmericans in 2000-2004 were from myeloma. Deaths Approximately 10. • The median age at diagnosis is 70. a B lymphocyte.1 5. Treatment Chemotherapy for myeloma has led to sustained remissions in some patients. In myeloma.900 (10. Treatment is aimed at slowing progress of the disease.000 to 3.3/100. 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. Sixty percent of those were diagnosed with the disease within the past four years.1/100. the patient’s own stem cells are used (autologous stem cell infusion).000) for all racial and ethnic groups. but it is the most difficult blood cancer to treat successfully. Lenalidomide is approved by the FDA in combination with dexamethasone for the treatment of myeloma patients who have received at least one prior therapy. The U. 15-19.8 14. Myeloma was the 10th most common cause of cancer deaths for women in 2000-2004. median age at death from multiple myeloma is 74. 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. the cell that forms plasma cells. Epidemiology and End Results) Cancer Statistics Review 1975-2004. Figure 9: Source: SEER (Surveillance.5/100. The highest rates are found in black men 80 to 84 years of age and older (105/100. It grows continuously and forms masses of plasma cells. *<16 cases for each age interval. • Americans of African descent have a much higher incidence rate.790 deaths from myeloma are anticipated this year. Patients may have anemia. and it rarely occurs in people under age 45. National Cancer Institute.000) 40 30 20 10 0 0-24 0.000).000) is 56 percent higher than for women (4. Total survival for white males.3 0. (11. 2007.4 35.1 0.0 37.424 people in the United States are living with myeloma. 20-24). especially in the marrow. SEER 17 areas (<1.1 28. 2000-2004 Incidence (per 100.940 women) new cases of myeloma will be diagnosed in the United States in 2007. two or three drugs are used simultaneously.5/100.2/100. destroying normal bone tissue.4 33. Recurrent infections may be an early sign of the disease. New Cases An estimated 19. Bortezomib has been approved for treating myeloma in patients who have had at least two prior therapies. approximately double. but primarily in the bone marrow. a type of white blood cell found in many tissues of the body. The mortality rate from myeloma for people of African descent is more than double the rate for whites (7. Treatment may include intensive chemotherapy followed by stem cell transplantation to restore normal blood cell production. 10-14. causing pain and crowding out normal blood cell production.9 9. From 2000 to 2004. Fractures may occur as a result of the weakened bones.1 Signs and Symptoms Often the first symptom of myeloma is bone pain caused by the effects of myeloma cells in the marrow. The onset of myeloma interferes with normal production of antibodies and makes myeloma patients susceptible to infections. Thalidomide is approved by the FDA for use in treating newly diagnosed myeloma.000).5 3. 5-9.Myeloma Myeloma is a cancer of the plasma cells.7 1. becomes malignant.000) of myeloma than those of European descent (5. It is 71 for African-Americans. • The incidence rate in men (7/100.
9 2.) Incidence Rates by Gender.1 2.1 11. the most recent available.4 4. Hodgkin and non-Hodgkin lymphoma and myeloma use figures from 2000-2004.2 6. Epidemiology and End Results) Cancer Statistics Review 1975-2004.0 7.3 2.2 14.8 14.5 Incidence Rates by Gender.) LEUKEMIA page 14 LYMPHOMA MYELOMA .0 2.0 Female 9.1 9.7 24. 2007.9 17.5 Table 8: Source: SEER (Surveillance. (Based on SEER 17 areas.5 16.3 Male 13. All Races. Rates are per 100. Epidemiology and End Results) Cancer Statistics Review 1975-2004.1 Table 10: Source: SEER (Surveillance.6 Male 16. National Cancer Institute.6 Female 9. per 100.0 23. per 100. 2007. Epidemiology and End Results) Cancer Statistics Review 1975-2004.7 5.4 11.9 5.000 population and are age-adjusted to the 2000 population.Incidence Rates: Leukemia. National Cancer Institute.6 2.2 3.000 Population (2000-2004) Type Leukemia Non-Hodgkin lymphoma Hodgkin lymphoma Myeloma Overall 12.3 19.8 20.0 Female 8.2 Male 16.3 2.2 18. 2007. National Cancer Institute. Lymphoma and Myeloma The following tables showing incidence rates for leukemia.6 4. for Blacks. for Whites. Incidence Rates by Gender.1 3.000 Population (2000-2004) Type Leukemia Non-Hodgkin lymphoma Hodgkin lymphoma Myeloma Overall 10.000 Population (2000-2004) Type Leukemia Non-Hodgkin lymphoma Hodgkin lymphoma Myeloma Overall 12. (Based on SEER 17 areas.2 2.) Table 9: Source: SEER (Surveillance. per 100. (Based on SEER 17 areas.
310 800 600 900 920 330 1. 2007 State Leukemia Non-Hodgkin Lymphoma Myeloma Hodgkin Lymphoma Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Dist.370 250 280 2.S.080 600 7.300 470 90 100 750 430 300 220 290 310 110 320 420 660 350 170 500 80 110 130 90 600 120 1..Estimated New Cases of Blood Cancers by Site. 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 2.170 480 1. 2007.240 170 550 130 800 3. by State. total because of rounding and exclusion of estimates that are fewer than 50 cases.140 60 260 80 410 1. American Cancer Society.190 880 870 170 100 4.140 380 140 1.830 240 230 60 * 1.150 290 270 70 * 1. Used with permission.030 570 * 610 210 360 1. **State estimates may not add up to U.530 1. Used with permission. American Cancer Society. Centers for Disease Control and Prevention.070 Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Dist. and additional data supplied by the American Cancer Society. They cannot be compared with previous years’ estimates to determine cancer incidence trends.S.660 210 * 190 120 1. Note: These estimates are offered as a rough guide and should be interpreted with caution. which is new for 2007.510 500 60 70 900 380 220 160 280 430 100 370 460 730 310 170 400 70 110 120 80 650 120 1.070 80 330 70 480 1. 2006.360 610 * 950 290 260 1. Numbers are rounded to the nearest 10.880 240 250 50 50 1.370 100 * 430 380 130 350 * 19.550 2. January/February 2007.360 960 170 220 2.410 130 50 500 490 130 490 * 21.190 290 * 280 200 1. and additional data supplied by the American Cancer Society based on data from the U.500 430 1.710 570 500 2. LEUKEMIA LYMPHOMA MYELOMA page 15 . is described by Pickle et al.520 310 3. 2007.240 740 80 1. CA A Cancer Journal for Clinicians.160 1.010 1. Table 12: Sources: Cancer Facts & Figures 2007. *Estimate is fewer than 50 cases. numbers are small and NCI and ACS are having difficulty fitting them into the Pickle et al.S.680 920 340 890 170 290 330 190 1. Numbers are rounded to the nearest 10.030 910 620 420 680 680 250 630 1.260 220 400 420 290 2.550 * * * * *20 * * * * 60 * * * 50 * * * * * * * * * * * * * * * * * * 70 * * 50 * * 60 * * * * 80 * * * * * * * 390 Table 11: Sources: Cancer Facts & Figures 2007.040 70 44.410 560 * 740 230 230 930 70 300 50 350 1.790 330 * 320 200 1. **State estimates may not add up to U.610 150 2. Note: These estimates are offered as a rough guide and should be interpreted with caution.130 300 80 900 960 300 1. National Center for Health Statistics.560 770 890 3.610 670 610 110 60 3. model (see below).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. *Estimate is fewer than 50 cases.330 260 780 180 1.540 1.160 140 50 360 440 170 320 * 18. Mortality Public Use Data Tapes.180 4.250 1.630 540 80 120 990 510 310 230 320 330 100 390 490 770 400 210 460 80 150 160 100 680 120 1.080 1.070 110 1. ***Hodgkin lymphoma estimates are not available for 2007.200 350 4. 2007 State Leukemia Non-Hodgkin Lymphoma Myeloma Hodgkin Lymphoma*** Estimated Deaths from Blood Cancers by Site.300 110 63.390 1. by State. 1969-2004.670 1. The method of derivation. 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. total because of rounding and exclusion of estimates that are fewer than 50 cases.
Because of reporting delays from some of the SEER regions.S. When expressed as a rate. only the first diagnosed cancer counts.S. survival and mortality have been revised. no matter how long ago that diagnosis was. 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.S.. race or sex.” as per SEER table I-21. Thus. so the exact number of cases is not known. especially in looking at populations in which individuals have had more than one type of cancer. his or her survival with leukemia may not be counted in leukemia prevalence statistics.Notes and Definitions Notes The United States does not have a nationwide reporting system or registry for blood cancers. but these figures do not take into account differences in geography. The description of the methods used was published in Pickle et al. cancer or otherwise. CA A Cancer Journal for Clinicians. Incidence rates can be calculated based on a number of factors such as age. The data presented in this report are an extrapolation or estimate of the number of cases reported by the 17 Surveillance.) Prevalence is the estimated number of people alive on a certain date in a population who previously had a diagnosis of the disease. The SEER (17 region) data cover only about 26 percent of the U. 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. state-by-state data for incidence of Hodgkin lymphoma are not available because these numbers are so small. if a person is initially diagnosed with melanoma and later develops leukemia. prevalence numbers reported may vary depending upon the method used to determine them. 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. may be incomplete in some cases and the data may reflect adjustments that anticipate changes that will occur once the actual data are received. This change means that the 2007 incidence estimates are not comparable with previous estimates for determining cancer incidence trends. The specified date is 1/1/2004 for the prevalence estimates. the American Cancer Society changed its method of estimating cancer incidence. Prevalence may be calculated in a number of different ways. it is the number of new cases per standard unit of population during the time period. Because of this change in method. Thus. population. based on the “first invasive tumor for each cancer site diagnosed during the previous 29 years (1975-2003). Bureau of the Census’ 2000 population data for that region. in comparison to the 2002 SEER report. 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. in some cases fewer than 17 SEER regions) and death data from the National Center for Health Statistics. The relative survival rate is a comparison of survival to a person who is free of the disease. This year. mostly upward. In this report. 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. 2007. 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. Relative survival rate is an estimate of the percentage of patients who would be expected to survive the effects of the cancer. It includes new (incidence) and preexisting cases and is a function of both past incidence and survival. estimates of cancer incidence. It considers deaths from all causes. In some prevalence statistics. LEUKEMIA page 16 LYMPHOMA MYELOMA . the data presented in the 2007 SEER report placed online on April 15. Definitions Incidence is the number of newly diagnosed cases for a specific cancer or for all cancers combined during a specific time period. Epidemiology and End Results Program (SEER) regions (or. The data can be extrapolated for the entire United States by multiplying by the population ratio.” We are using the “29-year limited duration” prevalence figures. (Observed survival is the actual percentage of patients still alive at some specified time after diagnosis of cancer. Because of changes in the information — such as racial classification — gathered in the 2000 U.S. population) that belong to the National Program of Cancer Registries. January/February 2007. race and ethnicity in various regions and region-specific health risks. Census.
posted to the SEER Web site 2007. http://www. Feuer EJ. Ross J.” Mattano L Jr. National Cancer Institute.cancer. Hachey M. p. http://seer. “Cancer Statistics. based on November 2006 SEER data submission.com/cgi/content/full/12/1/20. Trends. Ward E.” O’Leary M. Barr R. Bleyer A. Atlanta: American Cancer Society. Horner MJ. Bleyer A. Jemal A. Ries LAG (eds). Ries LAG (eds). Zou Z. Reichman M. No. O’Leary M. Including SEER Incidence and Survival: 1975-2000. 06-5767. Howe HL. pp. 2007. January/February.Citations Source Citations Cancer Facts & Figures 2007. NIH Pub. 2007. MD. 2007. 57. 174. and End Results) Cancer Statistics Review. 2006. MD. pp. Sheaffer J. 39-51. “A New Method of Estimating United States and State-Level Cancer Incidence Counts for the Current Calendar Year. Shu X-O. Ries LAG (eds). 25-38. Howlader N. National Cancer Institute. “Highlights and Challenges. Bethesda. Bethesda. Ries LAG. pp. Barr R. O’Leary M.” Bleyer A.” Hayat MJ. In Cancer Epidemiology in Older Adolescents and Young Adults 15 to 29 Years of Age. Melbert D. Bleyer A. CA A Cancer Journal for Clinicians Vol. Bethesda.gov/csr/1975_2004/ LEUKEMIA LYMPHOMA MYELOMA page 17 . Feuer EJ. Barr R. Reichman ME. 065767. 1975-2004. No. 20-37. Stock W. MD. 2007.” Pickle LW. Barr R. Nachman J. In Cancer Epidemiology in Older Adolescents and Young Adults 15 to 29 Years of Age. January. 065767. Keller F. Epidemiology. Miller BA. Edwards BK (eds). Howlander N. No. Including SEER Incidence and Survival: 1975-2000. 30-42. NIH Pub. Edwards BK. 2006. http://caonline. Hao Y. 12. Mariotto A. In Cancer Epidemiology in Older Adolescents and Young Adults 15 to 29 Years of Age. Including SEER Incidence and Survival: 1975-2000.org/cgi/content/full/57/1/30. The Oncologist Vol. “Lymphomas and Reticuloendothelial Neoplasms. National Cancer Institute. National Cancer Institute. Tiwari RC. Eisner MP. Epidemiology. O’Leary M. Bethesda.TheOncologist. SEER (Surveillance. Krapcho M. MD. Cheson B. Atlanta: American Cancer Society. pp. and End Results (SEER) Program. 2006. Clegg L. “Leukemias.amcancersoc. NIH Pub. Cancer Facts & Figures for African Americans 2007-2008. and Multiple Primary Cancer Analyses from the Surveillance.
lymphoma and myeloma research comprise four review subcomittees.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. The participating scientists may be at different institutions or from any country.25 million.000 per year for three years. 2) CDP-clinical research. or control of. 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 . lymphoma or myeloma. Since the first funding in 1954. Hodgkin’s disease and myeloma.000 over three years. We offer a wide variety of programs and services in support of our mission: Cure leukemia. research reaching a clinical trial can receive $1 million over five years to facilitate new drug discovery or advances in diagnosis or prevention. each focused on the discovery of new approaches to benefit patients or those at risk for developing leukemia.000 over five years.000 over five years. are granted each year. diagnosis or prevention in the near term. • Fellows are awarded $50. Research Research Grant Programs The Society’s research programs are based on the belief that all scientifically sound approaches toward a cure for. treatment or prevention of leukemia. 3) Translational Research Program. lymphoma. lymphoma and myeloma.000 a year for a total of $550.000 a year for a total of $180. Now supporting $61. and improve the quality of life of patients and their families. • Special Fellows are awarded $60. Translational Research Awards are made for an initial three-year period. Thus. Awards go to those groups that best demonstrate the synergy that will occur from their close interaction. Career Development Program The Career Development Program supports promising young scientists (Scholars. The SCOR program brings together research teams working in complementary areas. 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. the Society has awarded more than $550 million in research grants. The Society is a nonprofit organization that relies on the generosity of individual and corporate contributions to advance its mission.000 a year for a total of $180. The Specialized Center of Research (SCOR) in Leukemia. • Special Fellows in Clinical Research are awarded $60. Each SCOR is funded up to $1.6 million annually on research. Awards up to $200.000. for a total of $600.000 over three years. Translational Research Program The Translational Research Program provides early-stage support for research on leukemia.000 a year for a total of $150. The SCOR grants also support scientific core laboratories to provide access to innovative technology if required by the participating research programs. They are: 1) Career Development Program (CDP)-basic research. leading to better survival rates and prevention measures for patients. lymphoma and myeloma that is intended to advance treatment. the Society’s grant programs are among the most prestigious in the fields of blood cancers. The Grant Review Process Scientists and physician-scientists who are experts in the field of leukemia. Translational Research • Scholars in Clinical Research are awarded $110. lymphoma and myeloma should be encouraged worldwide. Funding for two additional years may be provided for highly promising projects that are entering phase I clinical trial. Translational Research and the Specialized Center of Research (SCOR).000 a year for a total of $550. leukemia. Research grants are awarded in three program areas: Career Development.25 million per year over a five-year period. to a total cost of $6. Special Fellows and Fellows) pursuing careers and is stratified into two separately reviewed programs in basic or clinical research: Basic Research • Scholars are awarded $110.000 over three years. The program is expected to generate new knowledge and breakthrough discoveries.
org/copay.m.org. and applications for the Society’s three research programs may be obtained by visiting www. You may also chat online with an information specialist.” Chapter Programs: Family Support Groups: The Society has developed more than 360 Family Support Groups at 68 chapters. Patients. Family Support Group locations. treatment and prevention of leukemia. their families and healthcare professionals. Much of the content of these materials is available to view and download at www.LLS. The Society funds several Focused Workshops each year on important topics relevant to hematological malignancies.LLS.m. This support should advance the understanding.org. The educational program offers varying formats to facilitate the exchange of information and ideas on the newest developments in cancer research and treatment.LLS. The user has the opportunity to create personalized pages with identified interests.org. sponsored by the Society. where medical professionals share the latest research findings. on the Society’s Web site. clinical trials and offer guidance on coping. www.LLS. First Connection: This program links newly diagnosed patients to a peer volunteer who has experienced a similar diagnosis. treatments. is held each December on the Friday immediately before the American Society of Hematology meeting. The Society also hosts numerous teleconferences and Webcasts. As of June 30. instructions. Guidelines. the Society’s programs and services. It is continually being updated and expanded to support and promote the Society’s mission.important projects to advance the Society’s mission. 9 a. to 5:00 p. Patient Services The Society has a network of 68 chapters throughout the United States and Canada. 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.org or by or emailing researchprograms@LLS.org. LEUKEMIA LYMPHOMA MYELOMA page 19 . www. www. lymphoma. Other meetings are held for the Society’s grantees.org. Co-Pay Assistance Program Patients with AML.org. The Society’s Web Site The Society’s Web site. ET. families and professionals may call the IRC toll free at (800) 955-4572 in addition to corresponding by email at infocenter@LLS. The Annual Research Symposium. peer counseling and patient financial aid. Patients needing assistance may apply on the Society’s Web site. lymphoma. These offices conduct lifeenhancing patient services. each group provides information and support. Guided by two volunteer oncology health professionals. The IRC is a worldwide link to information and resources useful to patients. Teleconferences and Webcasts The Society sponsors more than 25 educational teleconferences and Webcasts each year on topics of interest to patients and caregivers. ET. the Translational Research Grant Progress Review Meeting and the SCOR Progress Review Meeting. call (877) LLS-COPAY ( 557-2672) or email copay@LLS. 2007 the Society will have 379 active grantees at 116 institutions in the United States and abroad. Information on registration for these free events can be accessed at www. and encourages greater communication among patients. families. myelodysplastic syndromes (MDS) and other blood cancers. Information specialists are oncology social workers and health educators who provide callers with current information on blood cancers. friends and healthcare professionals. serves a wide variety of education and information needs. to 6 p. These include the Stohlman Scholar Symposium.LLS.org or faxing to (914) 949-6691 or contacting the Research Department at (914) 949-5213. The site features a comprehensive overview of blood cancers. podcasts and Webcast archives of these programs are available at www. audio.m. myeloma. Educational Materials An extensive collection of free educational materials are offered to patients and health professionals.m. from 10:00 a. They are available to talk one-onone. including support groups. the Society distributes more than 1 million booklets. brochures and videos through the IRC and local Society chapters. Monday through Friday. and click “Live Help. A trained patient volunteer currently in remission phones the new patient to share information and support.LLS. Information Resource Center (IRC) The Society strives to be the world’s foremost source of information on leukemia. Each year. Professional Education The Society serves the continuing educational needs of the medical and research community through professional symposia offered throughout the year. information about our peer-to-peer program First Connection and other programs.LLS. lymphoma and myeloma.org.
The Path to Progress: Clinical Trials in Blood Cancers: This program provides patients. In 2002. The patient education program was funded at $18 million through 2007. 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. emerging therapies and side effects and addresses the unique challenges of nursing management of these patients. the Society’s advocacy program has been a strong voice in Washington. Welcome Back: Facilitating the Return to School for Children with Cancer: A new addition to The Trish Greene Back to School Program. In 2001. The Society has identified key issues that currently shape its advocacy agenda. staging and classification of nonHodgkin lymphoma (NHL). This program is being sponsored by an unrestricted education grant from Novartis Oncology. parents. CML Issues and Insights: A Nursing Education Program on Chronic Myelogenous Leukemia. On the state level. This program is provided through an unrestricted educational grant from Millennium Pharmaceuticals. this education program discusses possible emotional and cognitive short. that program has funded some $30 million in additional blood cancer research. New Directions in Myeloma Therapy: This program presents an overview of myeloma. 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. families and healthcare professionals with a clear description of what clinical trials are. how cancer drugs are developed and what the emerging treatment options are for leukemia.000 and has become a potent voice in public policy deliberations. This program is also accessible as a Webcast at www. and offers numerous resources that can assist childhood cancer survivors to flourish in the school environment posttreatment. Department of Defense’s medical research program. reimbursement of up to $500 per year helps cover the costs of transportation. The Trish Greene Back to School Program for Children with Cancer: This program is designed to increase communication among healthcare professionals. Meet the Expert on Non-Hodgkin Lymphoma: This program presents basic information on terminology. drugs and various treatments not covered by insurance. To date. Society volunteers and staff visit Capitol Hill regularly to lobby Congress in support of issues that impact research and patient care. the Society successfully lobbied Congress to institute a blood cancer research initiative as part of the U. That network now numbers more than 35. 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.Patient Financial Aid Program: For more than 31 years. 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. the Society has helped patients demonstrating a need for financial assistance cover a portion of their treatment costs. representing to policy makers at all levels of government the healthcare quality concerns and medical research interests of patients and their families. LEUKEMIA page 20 LYMPHOMA MYELOMA . This nursing education program provides an overview of CML.and long-term effects that children may experience after treatment. Working through chapters across the country. 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. This Society program is being supported by Celgene Corporation and Millennium Pharmaceuticals. patients and school personnel to assure youngsters a smooth transition from active treatment back to school. Advocacy Since 1994.org and is being sponsored by a generous.LLS. Patient financial aid funds are subject to availability. It is supported by Amgen Oncology. unrestricted educational grant from Genentech BioOncology and Biogen Idec Inc. providing additional support for blood cancer patients and their families nationwide. This program is made possible by the Lance Armstrong Foundation. New insights. diagnosis.S. DC. treatments. risk factors. treatments. emerging therapies and managing side effects and how to find emotional support when living with the illness. treatments and future directions for NHL are also discussed. videos and other materials to aid the process are available through all local chapters. Through the Patient Financial Aid Program. Printed literature. lymphoma and myeloma.
and Rebecca Siegel. This publication is designed to provide information in regard to the subject matter covered.seer. .Acknowledgements Additional data from SEER*Stat Databases at http://www. provided statistical assistance. Milton Eisner of SEER. It is distributed as a public service by The Leukemia & Lymphoma Society Inc. The Leukemia & Lymphoma Society extends special thanks to Myrna Watanabe..D. for compilation of data for this publication. of the American Cancer Society (ACS). with the understanding that the Society is not engaged in rendering medical or other professional services. provided ACS’s state-by-state statistics on myeloma and Hodgkin lymphoma.gov.cancer. NCI. Ph.
and improve the quality of life of patients and their families. The Society is a nonprofit organization that relies on the generosity of individual. corporate and foundation contributions to advance its mission.HELP.LLS.955. PS80 35M 6/07 . Suite 310 White Plains.LLS Information Resource Center (IRC): 800.4572 www.Home Office 1311 Mamaroneck Avenue. lymphoma. New York 10605 Tel: 888. Hodgkin’s disease and myeloma.org Our mission: Cure leukemia.
This action might not be possible to undo. Are you sure you want to continue?
We've moved you to where you read on your other device.
Get the full title to continue listening from where you left off, or restart the preview.