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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.
Epidemiology and End Results Program. This year. *except acute myelogenous leukemia (AML) and other. 19. page 16). The next SEER Cancer Statistics Review is expected to be published online in April 2008. someone is diagnosed with a blood cancer.730 people will die from lymphoma (1.070 from Hodgkin.444.380 new cases of lymphoma will be diagnosed in the United States (8. in April 2007.790 people will die from myeloma.790 people will die of leukemia. 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. 18. National Cancer Institute. • In 2007.349 Americans are living with leukemia. 2nd Edition.240 people will be diagnosed with leukemia. Mortality from the disease increased 24 percent. This statistic represents 143 people each day.660 from non-Hodgkin). From 1975 to 2004. lymphoma and myeloma decreased from 1995 to 2004 (the last year data were available). • Non-Hodgkin lymphoma is the fifth most common cancer in the United States.650 total cancer-related deaths. • In 2007. someone dies from a blood cancer.313 either have or are in remission from Hodgkin lymphoma. This year. 44. the National Cancer Institute’s Surveillance.seer. • This year. • Leukemia causes more deaths than any other cancer among children and young adults under the age of 20. 21. Hodgkin and non-Hodgkin lymphoma and myeloma will account for nearly 9.520 people in the United States will be diagnosed with leukemia. National Cancer Institute. lymphoma and myeloma will cause the deaths of an estimated 52. Epidemiology and End Results) Cancer Statistics Review. The data within Facts 2007-2008 reflect the most recent statistics available from SEER. nonacute myelogenous and monocytic leukemias Lymphoma: • There are 544. 1998. 63. These data were published online by SEER. 1975-2004. 19.920 new cancer cases diagnosed in the United States this year. and its age-adjusted incidence rose by nearly 84 percent from 1975 to 2004. • Every five minutes. 138. 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 218.953 either have or are in remission from non-Hodgkin lymphoma (NHL). Cancer Statistics Review 1975-2004 (see Notes. • In general. 405. Five-Year Relative Survival Rates 1960-1963 vs. lymphoma and myeloma in 2007. the likelihood of dying from most leukemias*. • These blood cancers will account for 9. Highlights from the Report Include: New Cases • An estimated 135. • Eighty-six percent of myeloma cases occur in people aged 55 and over. Myeloma: • • • • There are 60. 10. Survival • An estimated 823. Oxford University Press. the incidence of myeloma increased 8 percent. which becomes malignant and multiplies continuously. 2007 and SEER 19731993. *Myeloma Biology and Management. • Every 10 minutes. This abnormal accumulation interferes with the production of healthy blood cells.190 cases of Hodgkin. Deaths • Leukemia.Executive Summary Facts 2007-2008. • This year. LEUKEMIA LYMPHOMA MYELOMA page 1 .cancer.900 people will be diagnosed with myeloma.4 percent of the 1. 71.190 cases of non-Hodgkin). www. Leukemia. Hodgkin and non-Hodgkin lymphoma.310 people in the United States this year. 1960-1963 1975-1977 1996-2003 Figure 1: Sources: SEER (Surveillance. 1996.424 people living today with myeloma. and myeloma. is a compilation of the most recent data on leukemia. • New cases of leukemia.3 percent of the deaths from cancer in 2007 based on the 559.659 people in the United States who are either living with or are in remission from leukemia. or nearly six people every hour.266 people living today with lymphoma.gov. More males are diagnosed with leukemia and more males die of it than females.1975-1977 vs. an annual publication. • Thirty-two percent more males are living with leukemia than females. lymphoma and myeloma.
About the Diseases Leukemia. studies suggest that two matched cord donors may result in a higher success rate in larger adults. The technique is important. lymphoma and myeloma. Hodgkin and non-Hodgkin lymphoma and myeloma are cancers that originate in a cell in the bone marrow or lymphatic tissues. for which a parent rather than a sibling could be the donor. 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). Syngeneic transplant describes the use of an identical twin as donor. decreased ability to fight infections and a predisposition to bleeding. 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. 2007. An allogeneic transplant uses blood or marrow stem cells from a normal donor. Approximately 50 different drugs are now being used in the treatment of these diseases. If a sibling is not available.) of larger adult patients. usually a brother or sister with the same tissue type. The technique of harvesting stem cells from blood and cord blood has made transplantation available for more LEUKEMIA page 2 LYMPHOMA MYELOMA . Patients with acute lymphocytic leukemia (ALL). In special instances. Patients with leukemia. 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. Research is being conducted to improve socalled “haploidentical” transplant. myeloma and lymphoma are usually treated with chemotherapy. The blood or marrow stem cells are collected while the patient is in remission. 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. They are considered to be related cancers because they arise from cells with a common origin (the lymphohematopoietic stem cells) and with related functions. usually in combinations of two or more drugs. especially for children. a search of the National Marrow Donor Program registry of tissue-typed volunteers could be made for a matched unrelated donor. Autologous transplantation uses the patient’s own marrow stem cells and is technically not transplantation since another person is not the donor. The numbers of stem cells in cord blood are often insufficient for the needs Figure 2: Source: Cancer Facts & Figures. slightly mismatched cord stem cell donors may be used quite successfully. American Cancer Society. 2007. (Numbers do not add up to 100% because of rounding. some types of Hodgkin lymphoma. 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. These diseases usually result from an acquired genetic injury to the DNA of a single cell. The harvesting. Stem cells also circulate in large numbers in fetal blood and can be recovered from umbilical cord and placental blood after childbirth. especially in young children. freezing and storing of cord blood have provided another source of stem cells for transplantation. However. The accumulation of malignant cells interferes with the body’s production of normal blood or immune cells and can result in severe anemia. Such an approach would greatly lessen the proportion of children without a donor. which becomes abnormal (malignant) and multiplies continuously.
lymphoma or myeloma is attacked and suppressed by donor lymphocytes that form from the donor stem cells. Development of New Drugs: In the past decade. several important new drugs and new uses for existing drugs have greatly improved cure rates or remission duration for some patients with leukemia. Stem cells not only reside in the marrow but also circulate in the blood. ablation of the recipient’s blood-cell forming and immune cells was the price that had to be paid to eradicate the leukemia. the recipient’s blood cell and immune system are preserved. few severe adverse effects on normal tissues and a very high response rate. 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. identify recurrence of the disease and detect long-term or late effects.org/). The protein is an enzyme in the family of tyrosine kinases. Although a minority of patients have developed resistance to the drug. and Young Adult LEUKEMIA LYMPHOMA MYELOMA page 3 . Cancer survivors should see their primary care physicians for general health examinations and an oncologist for follow-up care related to cancer. To ensure there will be enough blood stem cells for successful transplantation. but some follow adult cancer survivors. 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. or genetic factors that can increase susceptibility to certain effects. Imatinib mesylate (Gleevec®) is now the drug of choice in newly diagnosed patients with chronic myelogenous leukemia (CML). Most follow-up clinics specialize in pediatric cancer survivors. making the procedure more tolerable. Follow-Up Guidelines: The Children’s Oncology Group has established Long-Term Follow-Up Guidelines for Survivors of Childhood. Regular examinations may include screening for cancer recurrence or the development of secondary cancer or other late effects of treatment. as well as marrow. Gleevec offers several dramatic advantages to patients: oral administration. In nonablative transplantation. 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. Identifying these biomarkers will allow researchers to develop tests that can predict what effects an individual is at risk of developing. Blood and cord blood transplants differ from marrow transplants principally in the source of the cells collected for transplant. frozen and stored and later transplanted in the patient. as needed. thereby allowing doctors to plan treatment accordingly. Adolescent. Over time. these cells can be harvested from the blood of a donor. Some treatment centers have follow-up clinics that provide a comprehensive. decreased side effects. lymphoma or myeloma and permit the donor’s cells to be accepted by the temporarily immunodeficient recipient. In standard stem cell transplantation. donors of blood stem cells require special treatment to mobilize sufficient stem cells from marrow into their blood before cells are harvested. New Approaches to Treatment Several areas of research have resulted in new approaches to the treatment of leukemia. “Ablation” referred to wipingout the recipient’s cancer. Follow-Up Care Regular medical follow-up enables doctors to assess the full effect of therapy. Cancers (http://www.childrensoncologygroup.patients. “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. Coordination between specialists and primary care physicians is essential to provide the best care possible. 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. 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. lymphoma or myeloma can have an allogeneic transplant. lymphoma and myeloma. is a source of stem cells for transplantation. Biomarkers could be high levels of certain substances in the body such as antibodies or hormones. the donor’s cells take hold and the patient’s leukemia. This “graft versus leukemia or lymphoma effect” can suppress (cure) the malignancy and is a prolonged (indefinite) form of immunotherapy. Cancer survivors should have physical examinations yearly or more often. It works by blocking the oncogeneencoded protein product that instigates the transformation to a leukemic cell. Because blood. multi-disciplinary approach to monitoring and supporting cancer survivors. marrow and immune system.
doxorubicin (Adriamycin®). PDGFR or KIT oncoproteins). 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. This drug is also being tested in clinical trials to treat adult acute leukemia and MDS. 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). a less common type of chronic lymphocytic leukemia (CLL). Pentostatin is another effective drug that can be used in patients with hairy cell leukemia who do not respond to cladribine. Gleevec is not only a very important new agent in the treatment of CML. In May 2006. Azacitidine (Vidaza®). Some patients with moderately severe. but without this specific chromosome 5 abnormality. approved by the FDA in 2005. although initially used in indolent lymphomas. lymphoma or myeloma. The treatment of hairy cell leukemia. Indeed. suppresses the progression of leukemia. 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. has improved dramatically with the introduction of cladribine. Patients with more severe forms of MDS are very unlikely to respond to the agent. Early studies indicate the combination of arsenic trioxide and all-trans retinoic acid may be a further advance in the initiation of therapy. such as follicular lymphoma. Other therapies in clinical research to treat MDS include arsenic trixoxide. is being used to treat relapsed or refractory acute lymphocytic leukemia (ALL) in children who have received at least two prior therapies. but it can also induce remissions in some cases of acute leukemia. Velcade is approved by the FDA for treating people with myeloma who have had at least one prior therapy. was approved by the FDA for newly diagnosed myeloma. however.S. the most prevalent lymphoma subtype. a thalidomide derivative. It is especially active against the lymphocytes in CLL. Monoclonal Antibody Therapy: Monoclonal antibodies are laboratory-produced proteins that can be infused into an appropriate patient. immune cell administration and vaccine development. thalidomide (Thalomid®). Immunotherapy: This is a treatment that uses immune cells or antibodies to fight the disease. Clofarabine (Clolar®). Rituximab has become an important agent to treat CD20-positive lymphocytic malignancies. perhaps 20 percent of cases also derive benefit. kill unhealthy bone marrow cells and may help the bone marrow function more normally in MDS patients. LEUKEMIA page 4 LYMPHOMA MYELOMA . farnesyl transferase inhibitors and reduced-intensity stem cell transplantation. 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. Revlimid is approved by the FDA in combination with dexamethasone for the treatment of myeloma patients who have received at least one prior therapy. and Decitabine (Dacogen®). thus rituximab is an anti-CD20 antibody. Food and Drug Administration [FDA] in 2006) and nilotinib (in clinical trials). Cladribine induces long-term remissions in nearly 90 percent of patients treated at diagnosis for one week. principally. in combination with dexamethasone. cyclophosphamide. In patients with anemia. vincristine (Oncovin®) and prednisone–therapy for diffuse large B-cell lymphoma. Three types of immunotherapy are being explored: antibody treatment. symptomatic anemia have improvement in hemoglobin levels with this agent. reducing the need for transfusions in some patients. Lenalidomide (Revlimid®). Rituximab is an antibody directed at the target CD20 antigen on B-cell lymphoma cells. it has now become an important fifth drug in the R-CHOP–rituximab. approved by the FDA for all types of MDS. chronic eosinophilic leukemia (formerly hypereosinophilic syndrome). are entering clinical use and can overcome this resistance in some cases. 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®). Monoclonal antibodies have added to the arsenal of agents that are used for the treatment of patients with lymphoma and leukemia. Alemtuzumab (Campath®) is a monoclonal antibody directed against the antigen CD52 found on T and B lymphocytes. and enhances the specificity of treatment to minimize toxic effects on normal tissues. Arsenic trioxide also adds to the drugs available to treat this subtype of acute leukemia.dasatinib (Sprycel®)(approved by the U. 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. Cell surface antigens have been given a cluster designation (CD) followed by a number.
Approaches to reversing multidrug resistance are under study. LEUKEMIA LYMPHOMA MYELOMA page 5 . Patients with myeloma have also had remission re-induced by donor lymphocytes. These types of vaccines would be used in patients who have small amounts of residual blood cancer after chemotherapy or stem cell transplantation. cells are isolated in the laboratory and start making antibodies after insertion of the cancer antigen. less responsive to therapy. In some approaches. Paradoxically. An alternative strategy called molecular targeted drug development targets the oncoprotein.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. Monoclonal antibodies can also be linked to a radioactive isotope to target and kill specific cancer cells. 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. 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 each case. 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. In studies of CML. lymphoma and myeloma. 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. In patients with CML who have relapsed after stem cell transplantation. or become. myeloma and leukemia. These cells are. This means that the vaccine induces an immune response against the cancer cells present in the patient. gene therapy researchers are trying to modify an oncogene (BCR-ABL) that produces a protein that stimulates malignant cell growth. Two new and potentially important approaches include a) the application of RNA interference. These drugs have been approved to treat relapsed B-cell non-Hodgkin lymphoma. They deliver the toxic substance directly to the cancer cells. drugs are designed to interfere with the oncoprotein and prevent its effect on the cell. gemtuzumab (Mylotarg®). In another approach. This drug. The goal of several new agents being studied is to decrease resistance to an important chemotherapy drug used in leukemia. the patient’s immune cells would be treated in the laboratory to train them to attack the residual leukemia. 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. Many cancer treatment vaccines under development are intended to induce antigen-specific antitumor immune responses. If the gene in the former case is an oncogene or the protein in the latter case is an oncoprotein. the infusion of the original marrow donor’s lymphocytes can re-induce remission. DNA vaccines that contain the DNA that encodes the specific antigen are being tested. and aptamer treatment. These are called conjugated monoclonal antibodies. some vaccines are made from leukemic cells treated in test tubes to convert them to potent antigen-presenting cells. a technique that prepares small molecules in the laboratory that have the ability to inactivate proteins that cause disease. 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. In one approach. new forms of cancer therapy may be developed. 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. Vaccines are in clinical trials for types of acute and chronic leukemia. Studies of vaccines used in patients with follicular or indolent lymphoma have demonstrated an immune response. 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. Examples of this treatment are the drugs ibritumomab (Zevalin®) and tositumomab and iodine I131 tositumomab (Bexxar®). is approved for older patients with AML who relapse after initial treatment. lymphoma or myeloma cells. Vaccines: Experimental treatment vaccines are now being studied to treat certain types of lymphoma.
340 13.Leukemia Leukemia is a malignant disease (cancer) of the bone marrow and blood. functionless cells in the marrow and blood. a deficiency of red cells. DCCPS. males are expected to account for 56 percent of the new cases of leukemia. Prevalence of the Four Major Leukemias as of Jan. aged 0-19. Table 3: Source: Cancer Facts & Figures 2007.960 7. The terms myelogenous or lymphocytic denote the cell type involved. Epidemiology.S.579 21. American Cancer Society. Approximate U. Leukemia is divided into four categories: myelogenous or lymphocytic. Statistical Research and Applications Branch.060 2.800 children. The marrow often no longer produces enough normal platelets. Only 2. • The most common form of leukemia in children is acute lymphocytic leukemia (ALL).570 19. based on the November 2006 SEER data submission.200 15.790). • Most cases of leukemia occur in older adults. Incidence by Gender Incidence rates* for all types of leukemia are higher among males than among females.240 Male 3. 2007.440 adults compared with 3.140 6.289 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 5.570 3. red blood cells and white blood cells.720 44. *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. 1. each of which can be acute or chronic.440 Table 2: Sources: SEER (Surveillance. The four major types of leukemia are shown in Table 1.570 5. released April 2007. and SEER Program. *Note: Incidence rates are the number of new cases in a given year not counting the preexisting cases. • About 33 percent of cancers in children aged 0-14 years are leukemia • Most cases of chronic myelogenous leukemia (CML) occur in adults. A shortage of platelets results in bruising and easy bleeding.4 percent of leukemias in children aged 0-19 are CML. 2004 Type Chronic lymphocytic leukemia Chronic myelogenous leukemia Acute lymphocytic leukemia Acute myelogenous leukemia Prevalence* 95. The lack of normal white cells impairs the body’s ability to fight infections. Chronic leukemia progresses more slowly and allows greater numbers of more mature.000 2. Acute leukemia is a rapidly progressing disease that results in the accumulation of immature. Chronic leukemias account for 7 percent more of the cases than acute leukemias.189 27.659 people in the United States are living with leukemia.800 Female 2. It is characterized by the uncontrolled accumulation of blood cells.501 50. functional cells to be made.060 8.150 24. develops in virtually all leukemia patients. NCI.240 new cases of leukemia will be diagnosed in the United States this year. more than half of all cases occur after age 67.350 2.380 6.S. Prevalence database: U. National Cancer Institute. Leukemia is expected to strike more than 10 times as many adults as children in 2007. New Cases An estimated 44. Nearly 54 percent of the new cases of this disease will occur among children in 2007 (about 2. 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. Anemia.) • The most common types of leukemia in adults are acute myelogenous leukemia (AML) and chronic lymphocytic leukemia (CLL). Surveillance Research Program. Estimated 29-Year L-D Prevalence Counts on 1/1/2004 by Duration. (About 40. 2007. and End Results) Cancer Statistics Review 1975-2004.410 4. The incidence rates are usually presented as a specific number per 100. LEUKEMIA page 6 LYMPHOMA MYELOMA . In 2007.000 population.
The cause of leukemia is not known. CLL incidence increases dramatically among people who are aged 50 and older.619 with ALL. LEUKEMIA LYMPHOMA MYELOMA page 7 . Hispanic children of all races under the age of 20 have the highest rates of leukemia. The incidence of ALL among 1. American Cancer Society.922 cases per year. In 25. Leukemia strikes all ages and both sexes. eighth and ninth decades of life.900 new cases of cancer diagnosed in African-Americans in 2007. From 1975 to 2000. Leukemia rates are substantially higher for Hispanic. leukemia rates are higher in Americans of European descent than among those of African descent. Possible Causes of Leukemia Anyone can get leukemia. These cancers are most prevalent in the seventh.to 29-year olds. ALL incidence was approximately twice that of AML. However.790 new cases of childhood ALL are expected to occur in 2007. 2007. 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). Children. They do warrant medical evaluation. It is estimated that in 2007.Estimated Proportion of New Cases (%) in 2007 for Each Type of Leukemia Including Adults and Children 3. averaging about 189. The incidence rate for all cancers among AfricanAmericans in the Seer (17 region). 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. These signs are not specific to leukemia and may be caused by other disorders. CML incidence also increases dramatically among people who are aged 60 and older. Leukemia incidence is highest among whites and lowest among American Indians/Alaskan natives. neither explains most cases. Incidence by Age-Group Incidence rates by age differ for each of the leukemias.800 children will be diagnosed with leukemia throughout the United States. Among 15. Although chronic exposure to benzene in the workplace and exposure to extraordinary doses of irradiation can be causes of the disease. Some people with chronic leukemia may not have major symptoms and are diagnosed during a medical examination. Most children under 15 years of age with ALL are cured. In the 17 SEER regions of the United States. Leukemia is one of the top 15 most frequently occurring cancers in minority groups. Adults. including the examination of the cells in blood or marrow. The most common form of leukemia among children under 20 years of age is ALL. AML incidence was approximately 1. About 2.000 population. including 3. and AML incidence increases dramatically in people who are aged 60 and older. white and Asian/Pacific islander children than for black children. The leukemias represented 27 percent of all cancers occurring among children younger than 20 years from 2000-2004. 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. The American Cancer Society estimates that there will be approximately 152.to 4-year-old children is more than nine times greater than the rate for young adults ages 20 to 24. from 2000-2004.799 children under the age of 20 diagnosed with leukemia from 2001-2004. Figure 3: Source: Cancer Facts & Figures 2007. was 504 per 100.5 times that of ALL.to 19-year olds. American Indian/Alaskan natives. the incidence of AML slowly rose while that of ALL steadily decreased in the period from late adolescence to older adulthood. The diagnosis of leukemia requires specific blood tests. Adolescents and Young Adults. there were 4.
The relative survival rates differ by age of the patient at diagnosis.9 25-29 1.9 20-24 0. All Types Leukemia. 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.9 15-19 0.8 percent • AML: 20.1 4.4 5-9 0. Complete remission means that there is no evidence of the disease and the patient returns to good health with normal blood and marrow cells. 2007. 54.7 7 5 3 1 0 1. gender. the five-year relative survival rates overall were: • ALL: 65. 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.3 percent overall.7 percent overall. when compared to a person without leukemia.8 1-4 0. Treatment of Leukemia The aim of treatment is to bring about a complete remission. By 1975-1977. the five-year relative survival rate had jumped to 35 percent.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.6 10-14 0.3 1.2 10.4 percent Five-Year Relative Survival Rates for All Ages.Age-Specific Incidence Rates for Acute Myelogenous Leukemia (All Races). National Cancer Institute. a complete remission (no evidence of disease in the blood or marrow) that lasts five years after treatment often indicates cure.4 <1 0. For acute leukemia.3 3. National Cancer Institute. LEUKEMIA page 8 LYMPHOMA MYELOMA . The five-year relative survival rate has more than tripled in the past 47 years for patients with leukemia. a patient had a 14 percent chance of living five years. In 1960-1963. Thirty-two percent more males than females are living with leukemia. During 1996-2003.2 15 13 11 9 7. Treatment centers report increasing numbers of patients with leukemia who are in complete remission at least five years after diagnosis of their disease.5 21. Epidemiology and End Results) Cancer Statistics Review 1975-2004.4 percent for children under 5 • CLL: 74. Epidemiology and End Results) Cancer Statistics Review 1975-2004.2 23 21 19 19. 90.000) 17 15. race and type of leukemia.6 2.2 1. 2007.1 for children under 15 • CML: 44. 2000-2004 25 23.1 Incidence (per 100. the overall relative survival rate was nearly 50 percent. Relapse indicates return of the cancer cells and the return of other signs and symptoms of the disease. and in 1996-2003.
leukemia will be the fifth most common cause of cancer deaths in men and the sixth most common in women. There will be an estimated 4.790 Male 820 2. Cancer Statistics Review.390 additional deaths. LEUKEMIA LYMPHOMA MYELOMA page 9 . In 2007.990 490 6.560 5. Despite this decline.320 Female 600 1. Implications of long-term survivals in acute stem cell leukemia of childhood treated with composite cyclic therapy. 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. 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. 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. American Cancer Society. 1975-2004. Blood. Zuelzer WW. deaths from leukemia are expected to be distributed in the following numbers: In 2007. 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.500 8. leukemia causes more deaths than any other cancer among children and young adults under age 20. 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. Deaths It is anticipated that approximately 21.990 deaths from AML and 490 deaths from CML.020 240 3. Non-Hispanic whites diagnosed with leukemia over the age of 44 had the highest death rates during this period. 2007. 1964:24:477-494.390 21. 2. Sources: 1.420 4.790 deaths in the United States will be attributed to leukemia in 2007: 12.680 12. SEER (Surveillance.420 deaths from ALL.500 deaths from CLL and 1. in Children Under 15 Years of Age. In 2007.710 9. unclassified forms of leukemia Total Overall 1.970 250 2.940 3.470 Table 4: Source: Cancer Facts & Figures 2007. There will be an estimated 8. 2007. National Cancer Institute. Unclassified forms of leukemia will account for 6.470 females. Epidemiology and End Results).Five-Year Relative Survival Rates for Acute Lymphocytic Leukemia.320 males and 9. Hispanics with leukemia who are under the age of 25 had the highest mortality rates from the disease between 1990 and 1999.
190 cases of Hodgkin lymphoma and 63.313 people living with Hodgkin lymphoma (active disease or in remission) and 405. In 2004. Immune suppression plays a role in some patients.9 per 100. or low. Both Hodgkin and non-Hodgkin lymphomas are more common in males than in females. 2007.190 71.670 Female 3.5 percent of all lymphomas diagnosed in 2007. It is the sixth most common cause of cancer deaths in males and in females. The groups are often classified as indolent or aggressive. Lymphoma results when a lymphocyte (a type of white blood cell) undergoes a malignant change and begins to multiply.3 per 100.7 percent of all cases of non-Hodgkin lymphoma will be diagnosed in children under 15 years of age this year. and each has prognostic factors that categorize it as more or less favorable. the difference was small. American Cancer Society.266 members of the U.8 percent. New Cases of Lymphoma by Gender. By ages 60 to 64.9 per 100. Hodgkin lymphoma has characteristics that distinguish it from all other cancers of the lymphatic system. Each histologic grouping is diagnosed and treated differently.Hodgkin lymphoma are higher in Americans of European descent than among those of African descent. 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.470 34. LEUKEMIA page 10 LYMPHOMA MYELOMA . malignant cell found in Hodgkin lymphoma tissues).190 63. eventually crowding out healthy cells and creating tumors that enlarge the lymph nodes or other sites in the body. The Epstein-Barr virus causes Burkitt’s lymphoma in Africa. The reasons for the development of non-Hodgkin lymphoma are not certain.990 32. while 0. including the presence of an abnormal cell called the ReedSternberg cell (a large.000 for males and 38. there are 138. population who are living with lymphoma. Hodgkin Lymphoma Hodgkin lymphoma is a specialized form of lymphoma and will represent about 11.380 Table 5: Source: Cancer Facts & Figures 2007. an average annual percentage increase of 2. they are 52.380 Americans will be diagnosed with lymphoma in 2007 (8. Incidence rates for Hodgkin lymphoma tend to be higher among males than among females. 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. Incidence by Gender Table 5 illustrates the breakdown of incidence of lymphoma by gender. 2007 Type Hodgkin lymphoma Non-Hodgkin lymphoma Total Male 4.953 people living with nonHodgkin lymphoma for a total of 544. intermediate and high grade.000 for females.000 at ages 20 to 24 for males and 1. Fifty-three percent of the blood cancers diagnosed are lymphomas. New Cases About 71.710 Total 8.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.000 for females. Age-specific incidence rates of non-Hodgkin lymphoma are 2. These risk factors explain only a small proportion of cases.720 28.6 per 100. in general whites have higher incidence rates than blacks.190 cases of non-Hodgkin lymphoma). The incidence of Hodgkin lymphoma is consistently lower than that of non-Hodgkin lymphoma. The bacterium Helicobacter pylori is associated with the development of lymphoma in the stomach wall.200 38. Living with Lymphoma In the United States in 2007. More than four percent of all cases of Hodgkin lymphoma diagnosed in 2007 will be in children under 15 years of age.S. Persons infected with the human immunodeficiency virus (HIV) have a much higher risk of developing lymphoma. After 50 to 54 years of age. rose by 84 percent from 1975 to 2004. incidence rates for non.
From ages 15 to 19. groin or in the abdomen. 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 1996-2003.5 percent. Incidence in Children The incidence of Hodgkin lymphoma among people under 20 years of age was 1.2 percent for Hodgkin lymphoma in people under 20 years of age. Deaths An estimated 19. Early stage. Survival for Children Five-year relative survival is 95. Non-Hodgkin lymphoma is the ninth most common cause of cancer death in males and the seventh in females in the United States. following leukemia (26. persistent fatigue. In children up to age 14 years.1 cases per 100.000 by ages 60 to 64. Even in the mid-1970s. and is the eighth most common cause of cancer death in that group. 4.8 percent) and neoplasms of the brain and other nervous tissue (17. 3. five-year relative survival for non-Hodgkin lymphoma is now 83. the highest incidence of non-Hodgkin lymphoma is in non-Hispanic whites. The incidence in this group decreased almost steadily and significantly between 1975 and 1999. In children from 0 to 19 years of age.5/1 million population). followed closely by Hispanic children of all races (24. The five-year relative survival rate for non-Hodgkin lymphoma patients has risen from 31 percent in whites in 1960-1963 to 63. Symptoms also often include fever. the highest incidence of non-Hodgkin lymphoma is in Asian/Pacific islanders. Five-year relative survival is now 95 percent for Hodgkin lymphoma in children aged 0 to 14 years. and non-Hodgkin lymphoma. widespread disease requires chemotherapy or chemotherapy and/or monoclonal antibody therapy with radiation.730 persons will die from lymphoma in the United States in 2007 (18.070 from Hodgkin lymphoma).660 from non-Hodgkin lymphoma. This represents a significant improvement in the rate of recovery. excessive tiredness.to 24year-old individuals. and more than 46-fold to 112.8 percent for all races in 1996-2003. In children under 20 years of age. sweating at night. chemotherapy or both may result in cures for most patients with Hodgkin lymphoma. Treatment Hodgkin lymphoma is often treated with radiation and chemotherapy. The most common early sign of other forms of lymphoma is also painless swelling of the lymph nodes – usually in the neck. About 2.4 cases per 100. Adolescents are more commonly diagnosed with Hodgkin lymphoma than young children. armpit or groin. loss of appetite and bone pain.5 percent.1 per 100.Among women. In the United States. Treatment for non-Hodgkin lymphoma sometimes includes vaccines and other forms of immunotherapy. Survival for Adults Hodgkin lymphoma is now considered to be one of the most curable forms of cancer. Radiation. comprising nearly 5 percent of all cancers diagnosed. localized non-Hodgkin lymphoma is sometimes treated with radiation.000 children in 2004. about 10.400 children under the age of 15 will be diagnosed with cancer in 2007. Non-Hodgkin lymphoma is the fifth most common cancer in Hispanics. Lymphomas (Hodgkin lymphoma. armpit. LEUKEMIA LYMPHOMA MYELOMA page 11 .000 persons at ages 80 to 84. night sweats. recurrent high fever. It has remained fairly constant since 1999. The rate increases more than 18 times to 45. Signs and Symptoms Signs and symptoms of Hodgkin lymphoma include painless swelling of lymph nodes in the neck. troublesome itching and weight loss.1 cases per 100. 1. Hodgkin lymphoma incidence rates are higher in adolescents and young adults than in adults in their middle years. Incidence in Adults The incidence of non-Hodgkin lymphoma increases with age.9 percent). depending on the tumor size.5 percent) are the third most common cancers in children. Death rates have been declining for Hodgkin lymphoma patients since the mid-1970s.000 people occur in 20. most children with nonHodgkin lymphoma did not live five years after diagnosis. Hispanics of all races have the second highest incidence rates of non-Hodgkin lymphoma after whites. cell type and location of the lymphoma. It is rarest among American Indian/ Alaskan native children. indigestion and abdominal pain. lymphomas are most commonly diagnosed in whites (24.0/1 million population).
000) 70 60 50 40 30 22. Table 6: Source: SEER (Surveillance.660 19. Epidemiology and End Results) Cancer Statistics Review 1975-2004.3 4.0 20 10 0 0.6 32.9 1.4 80.4 2.000) 5 4 3 2 1 0 0. 2000-2004 110 100 90 80 Incidence (per 100.1 102. American Cancer Society.2 4.1 0. Age-Specific Incidence Rates for Non-Hodgkin Lymphoma.4 4.1 3. National Cancer Institute.4 3.6 0. 2007.5 10.8 112. 2007.4 15. National Cancer Institute.9 3.0 0. Epidemiology and End Results) Cancer Statistics Review 1975-2004.9 7. 2007. National Cancer Institute. 2007.4 2.8 4.0 2.1 0.070 18.0 3.3 <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.8 3.9 4.730 Male 770 9.1 63.1 3.370 Female 300 9. LEUKEMIA page 12 LYMPHOMA MYELOMA . Epidemiology and End Results) Cancer Statistics Review 1975-2004.5 <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. * <16 cases for time interval.600 10.4 2.360 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 2007.4 2.0 45.2 1.1 4. 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 per time interval.060 9. 2000-2004 6 Incidence (per 100.8 2.Age-Specific Incidence Rates for Hodgkin Lymphoma.0 1.0 100.
960 men and 8.S. • The incidence rate in men (7/100.940 women) new cases of myeloma will be diagnosed in the United States in 2007. two or three drugs are used simultaneously. Myeloma was the 10th most common cause of cancer deaths for women in 2000-2004.000 to 3. • The median age at diagnosis is 70. the patient’s own stem cells are used (autologous stem cell infusion). Usually. becomes malignant. especially.900 (10. causing pain and crowding out normal blood cell production.0 37. 2000-2004 Incidence (per 100.000) for all racial and ethnic groups. National Cancer Institute. New Cases An estimated 19. approximately double.000). the cell that forms plasma cells. 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. 1-4.1 21. myeloma was the 10th most commonly diagnosed cancer among African-American men and women.2/100. has been increasing. 5-9. 2007. 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. 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 mortality rate from myeloma for people of African descent is more than double the rate for whites (7. *<16 cases for each age interval. especially in the marrow. Thalidomide is approved by the FDA for use in treating newly diagnosed myeloma. In myeloma. The onset of myeloma interferes with normal production of antibodies and makes myeloma patients susceptible to infections.Myeloma Myeloma is a cancer of the plasma cells.1 Signs and Symptoms Often the first symptom of myeloma is bone pain caused by the effects of myeloma cells in the marrow. 15-19. (11.000) 40 30 20 10 0 0-24 0. SEER 17 areas (<1. From 2000 to 2004. Recurrent infections may be an early sign of the disease. Patients may have anemia. median age at death from multiple myeloma is 74. a type of white blood cell found in many tissues of the body. Figure 9: Source: SEER (Surveillance. Bortezomib has been approved for treating myeloma in patients who have had at least two prior therapies. 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 Possible Causes The cause of myeloma is not known.1 28. Sixty percent of those were diagnosed with the disease within the past four years.1/100. LEUKEMIA LYMPHOMA MYELOMA page 13 . The U. Approximately 3 percent of all cancer-related deaths among AfricanAmericans in 2000-2004 were from myeloma.000) is 56 percent higher than for women (4.000). Treatment is aimed at slowing progress of the disease. Treatment may include intensive chemotherapy followed by stem cell transplantation to restore normal blood cell production.000).1 0. but it is the most difficult blood cancer to treat successfully. • Americans of African descent have a much higher incidence rate. • The median age at diagnosis for African-Americans is 67.5/100. but primarily in the bone marrow.000) of myeloma than those of European descent (5. 10-14.424 people in the United States are living with myeloma.790 deaths from myeloma are anticipated this year. a B lymphocyte. destroying normal bone tissue. At times.9 9. Epidemiology and End Results) Cancer Statistics Review 1975-2004.1 5. The highest rates are found in black men 80 to 84 years of age and older (105/100. Living with Myeloma An estimated 60.3 0.5 3. Total survival for white males. Malignant plasma cells produce an abnormal protein called monoclonal immunoglobulin. Fractures may occur as a result of the weakened bones. It grows continuously and forms masses of plasma cells. and it rarely occurs in people under age 45.5/100.4 33.3/100. Treatment Chemotherapy for myeloma has led to sustained remissions in some patients.8 14.4 35. It is 71 for African-Americans. Age-Specific Incidence Rates for Myeloma.7 1. tire more easily and feel weak. Deaths Approximately 10.
8 14.9 2.1 Table 10: Source: SEER (Surveillance. National Cancer Institute. Epidemiology and End Results) Cancer Statistics Review 1975-2004. 2007.2 14. (Based on SEER 17 areas. Rates are per 100.5 16.6 Female 9.3 2.1 3.000 Population (2000-2004) Type Leukemia Non-Hodgkin lymphoma Hodgkin lymphoma Myeloma Overall 12.000 population and are age-adjusted to the 2000 population. 2007.1 2.0 23.2 Male 16.) Table 9: Source: SEER (Surveillance.5 Incidence Rates by Gender.6 4. Lymphoma and Myeloma The following tables showing incidence rates for leukemia.2 2.0 Female 8.1 9. 2007.7 24. (Based on SEER 17 areas. per 100.4 11.9 5.0 7. the most recent available.1 11.6 2.) Incidence Rates by Gender. Epidemiology and End Results) Cancer Statistics Review 1975-2004. National Cancer Institute. All Races.0 Female 9.8 20.5 Table 8: Source: SEER (Surveillance.3 2.0 2. for Blacks.2 3.000 Population (2000-2004) Type Leukemia Non-Hodgkin lymphoma Hodgkin lymphoma Myeloma Overall 12.7 5.4 4.9 17. National Cancer Institute.3 Male 13. Incidence Rates by Gender. Hodgkin and non-Hodgkin lymphoma and myeloma use figures from 2000-2004.000 Population (2000-2004) Type Leukemia Non-Hodgkin lymphoma Hodgkin lymphoma Myeloma Overall 10. Epidemiology and End Results) Cancer Statistics Review 1975-2004. (Based on SEER 17 areas.2 6.6 Male 16.Incidence Rates: Leukemia.) LEUKEMIA page 14 LYMPHOMA MYELOMA . per 100.3 19. for Whites. per 100.2 18.
370 100 * 430 380 130 350 * 19. 2007.130 300 80 900 960 300 1. ***Hodgkin lymphoma estimates are not available for 2007. is described by Pickle et al.240 740 80 1. They cannot be compared with previous years’ estimates to determine cancer incidence trends.510 500 60 70 900 380 220 160 280 430 100 370 460 730 310 170 400 70 110 120 80 650 120 1.390 1. 2007.610 670 610 110 60 3. numbers are small and NCI and ACS are having difficulty fitting them into the Pickle et al. *Estimate is fewer than 50 cases. 1969-2004.410 130 50 500 490 130 490 * 21.140 380 140 1.080 1. and additional data supplied by the American Cancer Society based on data from the U. 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.S.250 1.200 350 4. National Center for Health Statistics. Note: These estimates are offered as a rough guide and should be interpreted with caution. Numbers are rounded to the nearest 10.410 560 * 740 230 230 930 70 300 50 350 1.190 880 870 170 100 4. Used with permission.610 150 2.550 * * * * *20 * * * * 60 * * * 50 * * * * * * * * * * * * * * * * * * 70 * * 50 * * 60 * * * * 80 * * * * * * * 390 Table 11: Sources: Cancer Facts & Figures 2007.660 210 * 190 120 1. by State.500 430 1.150 290 270 70 * 1.180 4..190 290 * 280 200 1.300 110 63.300 470 90 100 750 430 300 220 290 310 110 320 420 660 350 170 500 80 110 130 90 600 120 1. Mortality Public Use Data Tapes.550 2. which is new for 2007. model (see below). **State estimates may not add up to U. and additional data supplied by the American Cancer Society.560 770 890 3. Note: These estimates are offered as a rough guide and should be interpreted with caution.S.170 480 1. by State.630 540 80 120 990 510 310 230 320 330 100 390 490 770 400 210 460 80 150 160 100 680 120 1.140 60 260 80 410 1. Used with permission. American Cancer Society. total because of rounding and exclusion of estimates that are fewer than 50 cases.360 610 * 950 290 260 1. LEUKEMIA LYMPHOMA MYELOMA page 15 . CA A Cancer Journal for Clinicians. Numbers are rounded to the nearest 10.370 250 280 2. The method of derivation.070 Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Dist.260 220 400 420 290 2.520 310 3. **State estimates may not add up to U.030 910 620 420 680 680 250 630 1. 2006.330 260 780 180 1.240 170 550 130 800 3. *Estimate is fewer than 50 cases. 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 4.030 570 * 610 210 360 1.160 1.050 140 140 * * 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.830 240 230 60 * 1.040 70 44.Estimated New Cases of Blood Cancers by Site. January/February 2007.070 110 1.540 1.310 800 600 900 920 330 1.530 1. 2007 State Leukemia Non-Hodgkin Lymphoma Myeloma Hodgkin Lymphoma Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Dist.670 1.S.160 140 50 360 440 170 320 * 18.010 1.070 80 330 70 480 1.080 600 7.790 330 * 320 200 1.880 240 250 50 50 1. American Cancer Society.680 920 340 890 170 290 330 190 1. Table 12: Sources: Cancer Facts & Figures 2007. 2007 State Leukemia Non-Hodgkin Lymphoma Myeloma Hodgkin Lymphoma*** Estimated Deaths from Blood Cancers by Site.710 570 500 2. Centers for Disease Control and Prevention.360 960 170 220 2.
Census.) Prevalence is the estimated number of people alive on a certain date in a population who previously had a diagnosis of the disease. only the first diagnosed cancer counts. the data presented in the 2007 SEER report placed online on April 15. Epidemiology and End Results Program (SEER) regions (or. LEUKEMIA page 16 LYMPHOMA MYELOMA . in some cases fewer than 17 SEER regions) and death data from the National Center for Health Statistics. population) that belong to the National Program of Cancer Registries. 2007. This year. Incidence rates can be calculated based on a number of factors such as age. may be incomplete in some cases and the data may reflect adjustments that anticipate changes that will occur once the actual data are received. It considers deaths from all causes. based on the “first invasive tumor for each cancer site diagnosed during the previous 29 years (1975-2003). race or sex. (Observed survival is the actual percentage of patients still alive at some specified time after diagnosis of cancer. Because of reporting delays from some of the SEER regions. Bureau of the Census’ 2000 population data for that region.S. the American Cancer Society changed its method of estimating cancer incidence.S. The SEER (17 region) data cover only about 26 percent of the U. Definitions Incidence is the number of newly diagnosed cases for a specific cancer or for all cancers combined during a specific time period. so the exact number of cases is not known. The specified date is 1/1/2004 for the prevalence estimates. survival and mortality have been revised.S. The relative survival rate is a comparison of survival to a person who is free of the disease. 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. 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. Thus. race and ethnicity in various regions and region-specific health risks. It includes new (incidence) and preexisting cases and is a function of both past incidence and survival.S. prevalence numbers reported may vary depending upon the method used to determine them. The description of the methods used was published in Pickle et al. estimates of cancer incidence. population. January/February 2007.” We are using the “29-year limited duration” prevalence figures. especially in looking at populations in which individuals have had more than one type of cancer. Because of changes in the information — such as racial classification — gathered in the 2000 U. 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. if a person is initially diagnosed with melanoma and later develops leukemia. When expressed as a rate. 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.” as per SEER table I-21. Relative survival rate is an estimate of the percentage of patients who would be expected to survive the effects of the cancer. CA A Cancer Journal for Clinicians. 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 prevalence statistics. cancer or otherwise. it is the number of new cases per standard unit of population during the time period. Prevalence may be calculated in a number of different ways. mostly upward. 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. This change means that the 2007 incidence estimates are not comparable with previous estimates for determining cancer incidence trends. Because of this change in method. no matter how long ago that diagnosis was. state-by-state data for incidence of Hodgkin lymphoma are not available because these numbers are so small. but these figures do not take into account differences in geography. The data presented in this report are an extrapolation or estimate of the number of cases reported by the 17 Surveillance. In this report.. The data can be extrapolated for the entire United States by multiplying by the population ratio. 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. Thus.
Krapcho M. Ries LAG. No. 1975-2004. 2006. 12. National Cancer Institute. 065767. MD. 30-42. Bethesda.” Bleyer A. January. Nachman J. Barr R. Ward E. Hachey M. 2007. National Cancer Institute. Cancer Facts & Figures for African Americans 2007-2008. Including SEER Incidence and Survival: 1975-2000. Epidemiology. 39-51. NIH Pub. 2007. O’Leary M.amcancersoc. In Cancer Epidemiology in Older Adolescents and Young Adults 15 to 29 Years of Age. 20-37. Miller BA. NIH Pub. “Leukemias. MD. 2006. pp. In Cancer Epidemiology in Older Adolescents and Young Adults 15 to 29 Years of Age. Stock W. Sheaffer J. 2007. pp.gov/csr/1975_2004/ LEUKEMIA LYMPHOMA MYELOMA page 17 . Barr R. O’Leary M. Feuer EJ. Bethesda. Eisner MP. Ries LAG (eds). MD. 06-5767. Barr R. “A New Method of Estimating United States and State-Level Cancer Incidence Counts for the Current Calendar Year. Ries LAG (eds).TheOncologist. Including SEER Incidence and Survival: 1975-2000. Including SEER Incidence and Survival: 1975-2000. Keller F. “Cancer Statistics. Bleyer A. The Oncologist Vol. O’Leary M. Reichman ME. Zou Z. Cheson B. “Highlights and Challenges.” O’Leary M. Edwards BK (eds). Barr R. Feuer EJ. Melbert D. based on November 2006 SEER data submission.org/cgi/content/full/57/1/30. Jemal A.” Pickle LW. 065767. http://seer. National Cancer Institute. 57. 25-38. pp. pp. Hao Y. Bleyer A. Reichman M.Citations Source Citations Cancer Facts & Figures 2007. and End Results) Cancer Statistics Review. National Cancer Institute. Trends. Horner MJ. http://caonline. Shu X-O. Tiwari RC. MD. 174. Epidemiology. Bethesda.cancer. Edwards BK. Bleyer A. NIH Pub. 2006. Howe HL. Ries LAG (eds). CA A Cancer Journal for Clinicians Vol. Bethesda. “Lymphomas and Reticuloendothelial Neoplasms. Howlader N. p. posted to the SEER Web site 2007.com/cgi/content/full/12/1/20. http://www. and Multiple Primary Cancer Analyses from the Surveillance.” Hayat MJ. In Cancer Epidemiology in Older Adolescents and Young Adults 15 to 29 Years of Age. January/February. No. Ross J. 2007. and End Results (SEER) Program. Atlanta: American Cancer Society. Clegg L.” Mattano L Jr. No. Atlanta: American Cancer Society. SEER (Surveillance. Mariotto A. Howlander N.
The participating scientists may be at different institutions or from any country.000 over five years. Each SCOR is funded up to $1. or control of.25 million.000 over three years. lymphoma and myeloma should be encouraged worldwide. Now supporting $61. Translational Research Awards are made for an initial three-year period.6 million annually on research. for a total of $600.25 million per year over a five-year period.000 a year for a total of $550. treatment or prevention of leukemia.000 over three years.000 over three years. leading to better survival rates and prevention measures for patients. Since the first funding in 1954. The Grant Review Process Scientists and physician-scientists who are experts in the field of leukemia.000 a year for a total of $150. Translational Research • Scholars in Clinical Research are awarded $110. Translational Research Program The Translational Research Program provides early-stage support for research on leukemia.000 a year for a total of $180. leukemia. • Special Fellows are awarded $60. lymphoma and myeloma research comprise four review subcomittees. 3) Translational Research Program. Funding for two additional years may be provided for highly promising projects that are entering phase I clinical trial. the Society’s grant programs are among the most prestigious in the fields of blood cancers. • Special Fellows in Clinical Research are awarded $60. 2) CDP-clinical research.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.000 per year for three years. 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. lymphoma. Awards up to $200. 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 . each focused on the discovery of new approaches to benefit patients or those at risk for developing leukemia.000. The SCOR grants also support scientific core laboratories to provide access to innovative technology if required by the participating research programs. Research Research Grant Programs The Society’s research programs are based on the belief that all scientifically sound approaches toward a cure for. Thus. The program is expected to generate new knowledge and breakthrough discoveries. The Specialized Center of Research (SCOR) in Leukemia. The Society is a nonprofit organization that relies on the generosity of individual and corporate contributions to advance its mission. lymphoma and myeloma. Career Development Program The Career Development Program supports promising young scientists (Scholars. • Fellows are awarded $50. diagnosis or prevention in the near term. The SCOR program brings together research teams working in complementary areas. are granted each year. lymphoma and myeloma that is intended to advance treatment.000 over five 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. lymphoma or myeloma. research reaching a clinical trial can receive $1 million over five years to facilitate new drug discovery or advances in diagnosis or prevention. the Society has awarded more than $550 million in research grants. Awards go to those groups that best demonstrate the synergy that will occur from their close interaction. We offer a wide variety of programs and services in support of our mission: Cure leukemia. Hodgkin’s disease and myeloma. They are: 1) Career Development Program (CDP)-basic research. Research grants are awarded in three program areas: Career Development.000 a year for a total of $180. Translational Research and the Specialized Center of Research (SCOR). to a total cost of $6. and improve the quality of life of patients and their families.000 a year for a total of $550.
org.m. families and professionals may call the IRC toll free at (800) 955-4572 in addition to corresponding by email at infocenter@LLS. LEUKEMIA LYMPHOMA MYELOMA page 19 . to 5:00 p.m. brochures and videos through the IRC and local Society chapters. Patients. Information Resource Center (IRC) The Society strives to be the world’s foremost source of information on leukemia. information about our peer-to-peer program First Connection and other programs. The Annual Research Symposium. lymphoma and myeloma. call (877) LLS-COPAY ( 557-2672) or email copay@LLS. ET. sponsored by the Society. serves a wide variety of education and information needs. 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. Co-Pay Assistance Program Patients with AML. their families and healthcare professionals. 9 a. They are available to talk one-onone. Monday through Friday.m. The Society funds several Focused Workshops each year on important topics relevant to hematological malignancies. Each year. The Society’s Web Site The Society’s Web site.LLS. First Connection: This program links newly diagnosed patients to a peer volunteer who has experienced a similar diagnosis. on the Society’s Web site. You may also chat online with an information specialist. myelodysplastic syndromes (MDS) and other blood cancers. is held each December on the Friday immediately before the American Society of Hematology meeting. lymphoma. families. Guided by two volunteer oncology health professionals. ET. Much of the content of these materials is available to view and download at www. www.org. It is continually being updated and expanded to support and promote the Society’s mission. the Society distributes more than 1 million booklets. The educational program offers varying formats to facilitate the exchange of information and ideas on the newest developments in cancer research and treatment. The site features a comprehensive overview of blood cancers.LLS.org. treatments. audio. Educational Materials An extensive collection of free educational materials are offered to patients and health professionals. the Society’s programs and services. where medical professionals share the latest research findings. peer counseling and patient financial aid.” Chapter Programs: Family Support Groups: The Society has developed more than 360 Family Support Groups at 68 chapters. The IRC is a worldwide link to information and resources useful to patients. Information on registration for these free events can be accessed at www. The Society also hosts numerous teleconferences and Webcasts.org. to 6 p. and click “Live Help. Patient Services The Society has a network of 68 chapters throughout the United States and Canada.org or faxing to (914) 949-6691 or contacting the Research Department at (914) 949-5213.org. www. These offices conduct lifeenhancing patient services. These include the Stohlman Scholar Symposium. Family Support Group locations. The user has the opportunity to create personalized pages with identified interests. www.LLS. This support should advance the understanding.LLS.LLS. Patients needing assistance may apply on the Society’s Web site. the Translational Research Grant Progress Review Meeting and the SCOR Progress Review Meeting. A trained patient volunteer currently in remission phones the new patient to share information and support.LLS. Information specialists are oncology social workers and health educators who provide callers with current information on blood cancers. clinical trials and offer guidance on coping. Other meetings are held for the Society’s grantees. podcasts and Webcast archives of these programs are available at www. instructions. Teleconferences and Webcasts The Society sponsors more than 25 educational teleconferences and Webcasts each year on topics of interest to patients and caregivers. myeloma. Professional Education The Society serves the continuing educational needs of the medical and research community through professional symposia offered throughout the year. including support groups. treatment and prevention of leukemia. from 10:00 a. and applications for the Society’s three research programs may be obtained by visiting www. lymphoma. Guidelines. friends and healthcare professionals.org or by or emailing researchprograms@LLS.org. 2007 the Society will have 379 active grantees at 116 institutions in the United States and abroad.m. each group provides information and support. and encourages greater communication among patients.LLS.org/copay.important projects to advance the Society’s mission. As of June 30.
videos and other materials to aid the process are available through all local chapters. New Directions in Myeloma Therapy: This program presents an overview of myeloma. This program is made possible by the Lance Armstrong Foundation. This nursing education program provides an overview of CML. 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. Working through chapters across the country. 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. that program has funded some $30 million in additional blood cancer research. The Society has identified key issues that currently shape its advocacy agenda. On the state level. DC. lymphoma and myeloma. drugs and various treatments not covered by insurance. families and healthcare professionals with a clear description of what clinical trials are. treatments. parents. providing additional support for blood cancer patients and their families nationwide. the Society’s advocacy program has been a strong voice in Washington. The Trish Greene Back to School Program for Children with Cancer: This program is designed to increase communication among healthcare professionals. reimbursement of up to $500 per year helps cover the costs of transportation. the Society has helped patients demonstrating a need for financial assistance cover a portion of their treatment costs.Patient Financial Aid Program: For more than 31 years. representing to policy makers at all levels of government the healthcare quality concerns and medical research interests of patients and their families. Through the Patient Financial Aid Program. Meet the Expert on Non-Hodgkin Lymphoma: This program presents basic information on terminology. 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 patient education program was funded at $18 million through 2007. treatments and future directions for NHL are also discussed.000 and has become a potent voice in public policy deliberations. CML Issues and Insights: A Nursing Education Program on Chronic Myelogenous Leukemia. emerging therapies and managing side effects and how to find emotional support when living with the illness. risk factors.LLS. patients and school personnel to assure youngsters a smooth transition from active treatment back to school. emerging therapies and side effects and addresses the unique challenges of nursing management of these patients. 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. Patient financial aid funds are subject to availability. and offers numerous resources that can assist childhood cancer survivors to flourish in the school environment posttreatment. unrestricted educational grant from Genentech BioOncology and Biogen Idec Inc.and long-term effects that children may experience after treatment. In 2002. This program is also accessible as a Webcast at www. diagnosis. That network now numbers more than 35. It is supported by Amgen Oncology. Welcome Back: Facilitating the Return to School for Children with Cancer: A new addition to The Trish Greene Back to School Program. The Path to Progress: Clinical Trials in Blood Cancers: This program provides patients. This program is provided through an unrestricted educational grant from Millennium Pharmaceuticals. Advocacy Since 1994. staging and classification of nonHodgkin lymphoma (NHL). In 2001. New insights. This Society program is being supported by Celgene Corporation and Millennium Pharmaceuticals. this education program discusses possible emotional and cognitive short. how cancer drugs are developed and what the emerging treatment options are for leukemia. 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 successfully lobbied Congress to institute a blood cancer research initiative as part of the U. treatments.org and is being sponsored by a generous. Department of Defense’s medical research program. LEUKEMIA page 20 LYMPHOMA MYELOMA . This program is being sponsored by an unrestricted education grant from Novartis Oncology. Society volunteers and staff visit Capitol Hill regularly to lobby Congress in support of issues that impact research and patient care. Printed literature.S. To date.
gov. Milton Eisner of SEER. This publication is designed to provide information in regard to the subject matter covered.Acknowledgements Additional data from SEER*Stat Databases at http://www. provided statistical assistance. of the American Cancer Society (ACS). It is distributed as a public service by The Leukemia & Lymphoma Society Inc. Ph. The Leukemia & Lymphoma Society extends special thanks to Myrna Watanabe.seer. provided ACS’s state-by-state statistics on myeloma and Hodgkin lymphoma. and Rebecca Siegel. NCI..cancer. with the understanding that the Society is not engaged in rendering medical or other professional services. for compilation of data for this publication.D. .
4572 www.org Our mission: Cure leukemia.Home Office 1311 Mamaroneck Avenue. lymphoma.955.HELP. corporate and foundation contributions to advance its mission. The Society is a nonprofit organization that relies on the generosity of individual. PS80 35M 6/07 . New York 10605 Tel: 888.LLS Information Resource Center (IRC): 800. Suite 310 White Plains. and improve the quality of life of patients and their families.LLS. Hodgkin’s disease and myeloma.