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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.
Deaths • Leukemia. Hodgkin and non-Hodgkin lymphoma. 44. 71.900 people will be diagnosed with myeloma. lymphoma and myeloma decreased from 1995 to 2004 (the last year data were available).650 total cancer-related deaths. page 16).Executive Summary Facts 2007-2008. Oxford University Press.1975-1977 vs.953 either have or are in remission from non-Hodgkin lymphoma (NHL). Mortality from the disease increased 24 percent. and its age-adjusted incidence rose by nearly 84 percent from 1975 to 2004. 19. • Non-Hodgkin lymphoma is the fifth most common cancer in the United States.seer. 10. The data within Facts 2007-2008 reflect the most recent statistics available from SEER. • In 2007.730 people will die from lymphoma (1. lymphoma and myeloma will cause the deaths of an estimated 52.gov.cancer. Leukemia. From 1975 to 2004. 18. 405. Epidemiology and End Results Program.349 Americans are living with leukemia. • Every 10 minutes. LEUKEMIA LYMPHOMA MYELOMA page 1 . These data were published online by SEER. National Cancer Institute. • These blood cancers will account for 9. Cancer Statistics Review 1975-2004 (see Notes. or nearly six people every hour.920 new cancer cases diagnosed in the United States this year.3 percent of the deaths from cancer in 2007 based on the 559. which becomes malignant and multiplies continuously. Epidemiology and End Results) Cancer Statistics Review. • This year. the likelihood of dying from most leukemias*. • Every five minutes. 138. 2nd Edition.380 new cases of lymphoma will be diagnosed in the United States (8.190 cases of non-Hodgkin).790 people will die from myeloma. Five-Year Relative Survival Rates 1960-1963 vs. Highlights from the Report Include: New Cases • An estimated 135. • In general. 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. 1960-1963 1975-1977 1996-2003 Figure 1: Sources: SEER (Surveillance. National Cancer Institute. This abnormal accumulation interferes with the production of healthy blood cells.520 people in the United States will be diagnosed with leukemia. This year. • Leukemia causes more deaths than any other cancer among children and young adults under the age of 20. More males are diagnosed with leukemia and more males die of it than females.070 from Hodgkin. This statistic represents 143 people each day.790 people will die of leukemia.266 people living today with lymphoma. • New cases of leukemia. Survival • An estimated 823. 21.659 people in the United States who are either living with or are in remission from leukemia. 1996. www. 1998. someone is diagnosed with a blood cancer.444. lymphoma and myeloma in 2007. the National Cancer Institute’s Surveillance.424 people living today with myeloma.240 people will be diagnosed with leukemia. • In 2007. 2007 and SEER 19731993. 63. • This year.660 from non-Hodgkin). This year. *except acute myelogenous leukemia (AML) and other.190 cases of Hodgkin. in April 2007. and myeloma. is a compilation of the most recent data on leukemia. 1975-2004.313 either have or are in remission from Hodgkin lymphoma.4 percent of the 1. Hodgkin and non-Hodgkin lymphoma and myeloma will account for nearly 9. • Eighty-six percent of myeloma cases occur in people aged 55 and over. nonacute myelogenous and monocytic leukemias Lymphoma: • There are 544. 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.310 people in the United States this year. 19. someone dies from a blood cancer. lymphoma and myeloma. The next SEER Cancer Statistics Review is expected to be published online in April 2008. the incidence of myeloma increased 8 percent. an annual publication. *Myeloma Biology and Management. • Thirty-two percent more males are living with leukemia than females. Myeloma: • • • • There are 60.
If a sibling is not available. Patients with acute lymphocytic leukemia (ALL). some types of Hodgkin lymphoma. American Cancer Society. especially in young children. An allogeneic transplant uses blood or marrow stem cells from a normal donor. Syngeneic transplant describes the use of an identical twin as donor. 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. Autologous transplantation uses the patient’s own marrow stem cells and is technically not transplantation since another person is not the donor. Estimated New Cases (%) of Blood Cancers in 2007 Myeloma 15% Leukemia 33% Lymphoma 53% Treatment Chemotherapy and Radiotherapy: The use of chemotherapy (anticancer drugs). lymphoma and myeloma. The accumulation of malignant cells interferes with the body’s production of normal blood or immune cells and can result in severe anemia. Approximately 50 different drugs are now being used in the treatment of these diseases. usually in combinations of two or more drugs. (Numbers do not add up to 100% because of rounding. myeloma and lymphoma are usually treated with chemotherapy. 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. Stem cells also circulate in large numbers in fetal blood and can be recovered from umbilical cord and placental blood after childbirth. Research is being conducted to improve socalled “haploidentical” transplant. slightly mismatched cord stem cell donors may be used quite successfully. 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 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 . Such an approach would greatly lessen the proportion of children without a donor. 2007. 2007. Patients with leukemia. The technique is important. is largely responsible for the dramatic improvement in managing leukemia and lymphoma. 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. especially for children.) of larger adult patients. which becomes abnormal (malignant) and multiplies continuously. a search of the National Marrow Donor Program registry of tissue-typed volunteers could be made for a matched unrelated donor. studies suggest that two matched cord donors may result in a higher success rate in larger adults. The harvesting. The blood or marrow stem cells are collected while the patient is in remission. These diseases usually result from an acquired genetic injury to the DNA of a single cell. for which a parent rather than a sibling could be the donor. There are two major types of stem cell transplants: syngeneic and allogeneic. The numbers of stem cells in cord blood are often insufficient for the needs Figure 2: Source: Cancer Facts & Figures.About the Diseases Leukemia. In special instances. Hodgkin and non-Hodgkin lymphoma and myeloma are cancers that originate in a cell in the bone marrow or lymphatic tissues. decreased ability to fight infections and a predisposition to bleeding. However. 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. freezing and storing of cord blood have provided another source of stem cells for transplantation. 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.
frozen and stored and later transplanted in the patient. This still experimental approach greatly lessens the early toxicity of transplantation and has extended the age at which recipients with leukemia. Stem cells not only reside in the marrow but also circulate in the blood. Imatinib mesylate (Gleevec®) is now the drug of choice in newly diagnosed patients with chronic myelogenous leukemia (CML). making the procedure more tolerable. In standard stem cell transplantation. lymphoma or myeloma and permit the donor’s cells to be accepted by the temporarily immunodeficient recipient. thereby allowing doctors to plan treatment accordingly. as needed. Gleevec offers several dramatic advantages to patients: oral administration.org/). two second-generation agents. 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. Biomarkers could be high levels of certain substances in the body such as antibodies or hormones. multi-disciplinary approach to monitoring and supporting cancer survivors. or genetic factors that can increase susceptibility to certain effects. is a source of stem cells for transplantation. Over time. The protein is an enzyme in the family of tyrosine kinases. Blood and cord blood transplants differ from marrow transplants principally in the source of the cells collected for transplant. 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. Coordination between specialists and primary care physicians is essential to provide the best care possible. “Ablation” referred to wipingout the recipient’s cancer. Follow-Up Care Regular medical follow-up enables doctors to assess the full effect of therapy. Because blood. marrow and immune system.patients. New Approaches to Treatment Several areas of research have resulted in new approaches to the treatment of leukemia. lymphoma and myeloma. identify recurrence of the disease and detect long-term or late effects. Cancers (http://www. ablation of the recipient’s blood-cell forming and immune cells was the price that had to be paid to eradicate the leukemia. Cancer survivors should have physical examinations yearly or more often. 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.childrensoncologygroup. Adolescent. Cancer survivors should see their primary care physicians for general health examinations and an oncologist for follow-up care related to cancer. decreased side effects. Development of New Drugs: In the past decade. and Young Adult LEUKEMIA LYMPHOMA MYELOMA page 3 . Identifying these biomarkers will allow researchers to develop tests that can predict what effects an individual is at risk of developing. these cells can be harvested from the blood of a donor. “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. several important new drugs and new uses for existing drugs have greatly improved cure rates or remission duration for some patients with leukemia. 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. but some follow adult cancer survivors. few severe adverse effects on normal tissues and a very high response rate. It works by blocking the oncogeneencoded protein product that instigates the transformation to a leukemic cell. Regular examinations may include screening for cancer recurrence or the development of secondary cancer or other late effects of treatment. 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. Some treatment centers have follow-up clinics that provide a comprehensive. lymphoma or myeloma is attacked and suppressed by donor lymphocytes that form from the donor stem cells. the recipient’s blood cell and immune system are preserved. lymphoma or myeloma can have an allogeneic transplant. To ensure there will be enough blood stem cells for successful transplantation. as well as marrow. Most follow-up clinics specialize in pediatric cancer survivors. Although a minority of patients have developed resistance to the drug. donors of blood stem cells require special treatment to mobilize sufficient stem cells from marrow into their blood before cells are harvested. In nonablative transplantation. Follow-Up Guidelines: The Children’s Oncology Group has established Long-Term Follow-Up Guidelines for Survivors of Childhood.
however. The treatment of hairy cell leukemia. but without this specific chromosome 5 abnormality. was approved by the FDA for newly diagnosed myeloma. is being used to treat relapsed or refractory acute lymphocytic leukemia (ALL) in children who have received at least two prior therapies. thalidomide (Thalomid®). Other therapies in clinical research to treat MDS include arsenic trixoxide. doxorubicin (Adriamycin®). Pentostatin is another effective drug that can be used in patients with hairy cell leukemia who do not respond to cladribine. kill unhealthy bone marrow cells and may help the bone marrow function more normally in MDS patients. Arsenic trioxide also adds to the drugs available to treat this subtype of acute leukemia. Alemtuzumab (Campath®) is a monoclonal antibody directed against the antigen CD52 found on T and B lymphocytes. Some patients with moderately severe. chronic eosinophilic leukemia (formerly hypereosinophilic syndrome). perhaps 20 percent of cases also derive benefit. and enhances the specificity of treatment to minimize toxic effects on normal tissues. farnesyl transferase inhibitors and reduced-intensity stem cell transplantation. suppresses the progression of leukemia. 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 May 2006. 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. vincristine (Oncovin®) and prednisone–therapy for diffuse large B-cell lymphoma. Cladribine induces long-term remissions in nearly 90 percent of patients treated at diagnosis for one week. Indeed. approved by the FDA for all types of MDS. 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. approved by the FDA in 2005. a thalidomide derivative. Rituximab has become an important agent to treat CD20-positive lymphocytic malignancies. In patients with anemia. Monoclonal Antibody Therapy: Monoclonal antibodies are laboratory-produced proteins that can be infused into an appropriate patient. reducing the need for transfusions in some patients. Revlimid is approved by the FDA in combination with dexamethasone for the treatment of myeloma patients who have received at least one prior therapy. cyclophosphamide. are entering clinical use and can overcome this resistance in some cases. Gleevec is not only a very important new agent in the treatment of CML. such as follicular lymphoma. Food and Drug Administration [FDA] in 2006) and nilotinib (in clinical trials). immune cell administration and vaccine development. 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. Monoclonal antibodies have added to the arsenal of agents that are used for the treatment of patients with lymphoma and leukemia. lymphoma or myeloma. symptomatic anemia have improvement in hemoglobin levels with this agent. Patients with more severe forms of MDS are very unlikely to respond to the agent. LEUKEMIA page 4 LYMPHOMA MYELOMA . Three types of immunotherapy are being explored: antibody treatment. and Decitabine (Dacogen®). Early studies indicate the combination of arsenic trioxide and all-trans retinoic acid may be a further advance in the initiation of therapy.dasatinib (Sprycel®)(approved by the U. thus rituximab is an anti-CD20 antibody. It is especially active against the lymphocytes in CLL. a less common type of chronic lymphocytic leukemia (CLL). This drug is also being tested in clinical trials to treat adult acute leukemia and MDS.S. PDGFR or KIT oncoproteins). Azacitidine (Vidaza®). Clofarabine (Clolar®). Immunotherapy: This is a treatment that uses immune cells or antibodies to fight the disease. has improved dramatically with the introduction of cladribine. it has now become an important fifth drug in the R-CHOP–rituximab. in combination with dexamethasone. Lenalidomide (Revlimid®). Two additional drugs being studied in clinical trials have shown responses in a subset of patients with myeloma: the proteasome inhibitor bortezomib (Velcade®) and the immune modulator (Revlimid®). Rituximab is an antibody directed at the target CD20 antigen on B-cell lymphoma cells. the most prevalent lymphoma subtype. although initially used in indolent lymphomas. but it can also induce remissions in some cases of acute leukemia. principally. 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. Velcade is approved by the FDA for treating people with myeloma who have had at least one prior therapy.
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. lymphoma or myeloma cells. These are called conjugated monoclonal antibodies. b) a modality that uses molecules of RNA to silence complementary (DNA) genes. Two new and potentially important approaches include a) the application of RNA interference.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. In studies of CML. new forms of cancer therapy may be developed. and aptamer treatment. 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. DNA vaccines that contain the DNA that encodes the specific antigen are being tested. 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 types of vaccines would be used in patients who have small amounts of residual blood cancer after chemotherapy or stem cell transplantation. Vaccines: Experimental treatment vaccines are now being studied to treat certain types of lymphoma. The goal is to extend the duration of remission achieved by remissioninduction therapy of various types. gene therapy researchers are trying to modify an oncogene (BCR-ABL) that produces a protein that stimulates malignant cell growth. In some approaches. They deliver the toxic substance directly to the cancer cells. lymphoma and myeloma. the infusion of the original marrow donor’s lymphocytes can re-induce remission. Vaccines are in clinical trials for types of acute and chronic leukemia. If the gene in the former case is an oncogene or the protein in the latter case is an oncoprotein. 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. Many cancer treatment vaccines under development are intended to induce antigen-specific antitumor immune responses. is approved for older patients with AML who relapse after initial treatment. cells are isolated in the laboratory and start making antibodies after insertion of the cancer antigen. some vaccines are made from leukemic cells treated in test tubes to convert them to potent antigen-presenting cells. or become. In one approach. Paradoxically. 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. Patients with myeloma have also had remission re-induced by donor lymphocytes. the patient’s immune cells would be treated in the laboratory to train them to attack the residual leukemia. 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. Examples of this treatment are the drugs ibritumomab (Zevalin®) and tositumomab and iodine I131 tositumomab (Bexxar®). An alternative strategy called molecular targeted drug development targets the oncoprotein. myeloma and leukemia. 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. gemtuzumab (Mylotarg®). less responsive to therapy. 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. Studies of vaccines used in patients with follicular or indolent lymphoma have demonstrated an immune response. These drugs have been approved to treat relapsed B-cell non-Hodgkin lymphoma. drugs are designed to interfere with the oncoprotein and prevent its effect on the cell. Monoclonal antibodies can also be linked to a radioactive isotope to target and kill specific cancer cells. This drug. In another approach. a technique that prepares small molecules in the laboratory that have the ability to inactivate proteins that cause disease. Reversal of Multidrug Resistance: The malignant cells of patients have mechanisms that may allow them to escape the damaging effects of chemotherapy agents. Approaches to reversing multidrug resistance are under study. These cells are. LEUKEMIA LYMPHOMA MYELOMA page 5 .
2004 Type Chronic lymphocytic leukemia Chronic myelogenous leukemia Acute lymphocytic leukemia Acute myelogenous leukemia Prevalence* 95.570 3. The terms myelogenous or lymphocytic denote the cell type involved.060 8. each of which can be acute or chronic. Chronic leukemias account for 7 percent more of the cases than acute leukemias. Table 3: Source: Cancer Facts & Figures 2007.579 21. Epidemiology. • The most common form of leukemia in children is acute lymphocytic leukemia (ALL). • Most cases of leukemia occur in older adults. males are expected to account for 56 percent of the new cases of leukemia. functional cells to be made.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. In 2007. released April 2007. The lack of normal white cells impairs the body’s ability to fight infections.) • The most common types of leukemia in adults are acute myelogenous leukemia (AML) and chronic lymphocytic leukemia (CLL). red blood cells and white blood cells.410 4.380 6. National Cancer Institute.200 15. Only 2. 2007. based on the November 2006 SEER data submission.140 6.800 children. The incidence rates are usually presented as a specific number per 100. Statistical Research and Applications Branch. *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. *Note: Incidence rates are the number of new cases in a given year not counting the preexisting cases. (About 40.240 new cases of leukemia will be diagnosed in the United States this year.240 Male 3. • About 33 percent of cancers in children aged 0-14 years are leukemia • Most cases of chronic myelogenous leukemia (CML) occur in adults.440 adults compared with 3. Prevalence database: U. NCI. 2007. Estimated 29-Year L-D Prevalence Counts on 1/1/2004 by Duration.960 7. Incidence by Gender Incidence rates* for all types of leukemia are higher among males than among females.060 2. a deficiency of red cells.350 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 218.570 5.340 13. Chronic leukemia progresses more slowly and allows greater numbers of more mature.000 2. It is characterized by the uncontrolled accumulation of blood cells. Approximate U. A shortage of platelets results in bruising and easy bleeding.S.720 44. more than half of all cases occur after age 67. aged 0-19.501 50. The marrow often no longer produces enough normal platelets.Leukemia Leukemia is a malignant disease (cancer) of the bone marrow and blood.659 people in the United States are living with leukemia. Surveillance Research Program. Anemia. LEUKEMIA page 6 LYMPHOMA MYELOMA . Nearly 54 percent of the new cases of this disease will occur among children in 2007 (about 2.800 Female 2. and End Results) Cancer Statistics Review 1975-2004.000 population.S. Acute leukemia is a rapidly progressing disease that results in the accumulation of immature. Prevalence of the Four Major Leukemias as of Jan.790). functionless cells in the marrow and blood. American Cancer Society.4 percent of leukemias in children aged 0-19 are CML. develops in virtually all leukemia patients.189 27. DCCPS. Leukemia is expected to strike more than 10 times as many adults as children in 2007. 1.150 24. New Cases An estimated 44. Leukemia is divided into four categories: myelogenous or lymphocytic. The four major types of leukemia are shown in Table 1.570 19.440 Table 2: Sources: SEER (Surveillance. and SEER Program.
ALL incidence was approximately twice that of AML.900 new cases of cancer diagnosed in African-Americans in 2007. Incidence by Race and Ethnicity Incidence rates for all types of cancer combined are more than 5 percent higher among Americans of African descent than among those of European descent. and AML incidence increases dramatically in people who are aged 60 and older. 2007. About 2.to 19-year olds. From 1975 to 2000. Adults. Among 15.to 29-year olds. Adolescents and Young Adults. the incidence of AML slowly rose while that of ALL steadily decreased in the period from late adolescence to older adulthood.790 new cases of childhood ALL are expected to occur in 2007. The diagnosis of leukemia requires specific blood tests. including 3. Leukemia is one of the top 15 most frequently occurring cancers in minority groups. Incidence by Age-Group Incidence rates by age differ for each of the leukemias. Leukemia rates are substantially higher for Hispanic.5 times that of ALL. 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. It is estimated that in 2007. The cause of leukemia is not known. These signs are not specific to leukemia and may be caused by other disorders. Possible Causes of Leukemia Anyone can get leukemia. The most common form of leukemia among children under 20 years of age is ALL. The leukemias represented 27 percent of all cancers occurring among children younger than 20 years from 2000-2004. including the examination of the cells in blood or marrow. leukemia rates are higher in Americans of European descent than among those of African descent. Hispanic children of all races under the age of 20 have the highest rates of leukemia. averaging about 189. white and Asian/Pacific islander children than for black children.to 4-year-old children is more than nine times greater than the rate for young adults ages 20 to 24. CLL incidence increases dramatically among people who are aged 50 and older. American Indian/Alaskan natives. AML incidence was approximately 1. CML incidence also increases dramatically among people who are aged 60 and older. However. neither explains most cases.Estimated Proportion of New Cases (%) in 2007 for Each Type of Leukemia Including Adults and Children 3. Leukemia strikes all ages and both sexes.619 with ALL. The incidence of ALL among 1. They do warrant medical evaluation. Leukemia incidence is highest among whites and lowest among American Indians/Alaskan natives. The incidence rate for all cancers among AfricanAmericans in the Seer (17 region). 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).799 children under the age of 20 diagnosed with leukemia from 2001-2004. The American Cancer Society estimates that there will be approximately 152. was 504 per 100.922 cases per year. In 25. from 2000-2004.000 population. Some people with chronic leukemia may not have major symptoms and are diagnosed during a medical examination. Children. Most children under 15 years of age with ALL are cured. LEUKEMIA LYMPHOMA MYELOMA page 7 . In the 17 SEER regions of the United States.800 children will be diagnosed with leukemia throughout the United States. there were 4. Figure 3: Source: Cancer Facts & Figures 2007. Although chronic exposure to benzene in the workplace and exposure to extraordinary doses of irradiation can be causes of the disease. These cancers are most prevalent in the seventh. American Cancer Society. eighth and ninth decades of life.
3 1.6 2. a complete remission (no evidence of disease in the blood or marrow) that lasts five years after treatment often indicates cure.2 10. By 1975-1977. All Types Leukemia.4 5-9 0. LEUKEMIA page 8 LYMPHOMA MYELOMA . During 1996-2003.6 10-14 0. Relapse indicates return of the cancer cells and the return of other signs and symptoms of the disease.4 <1 0.4 percent Five-Year Relative Survival Rates for All Ages.9 25-29 1. 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. the five-year relative survival rates overall were: • ALL: 65.1 Incidence (per 100. The relative survival rates differ by age of the patient at diagnosis.1 for children under 15 • CML: 44. and in 1996-2003. Treatment of Leukemia The aim of treatment is to bring about a complete remission.5 21. when compared to a person without leukemia. National Cancer Institute.3 percent overall. 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.3 3. Thirty-two percent more males than females are living with leukemia. 90. gender.9 20-24 0.2 1. 2000-2004 25 23. In 1960-1963. race and type of leukemia. the overall relative survival rate was nearly 50 percent.8 1-4 0.4 percent for children under 5 • CLL: 74. 54. For acute leukemia.9 15-19 0.Age-Specific Incidence Rates for Acute Myelogenous Leukemia (All Races). Epidemiology and End Results) Cancer Statistics Review 1975-2004. Epidemiology and End Results) Cancer Statistics Review 1975-2004.7 7 5 3 1 0 1.1 4.000) 17 15. a patient had a 14 percent chance of living five years. 2007.7 percent overall.8 percent • AML: 20. the five-year relative survival rate had jumped to 35 percent. 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 five-year relative survival rate has more than tripled in the past 47 years for patients with 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. National Cancer Institute. Treatment centers report increasing numbers of patients with leukemia who are in complete remission at least five years after diagnosis of their disease.2 15 13 11 9 7. 2007.2 23 21 19 19.
leukemia will be the fifth most common cause of cancer deaths in men and the sixth most common in women.390 additional deaths. unclassified forms of leukemia Total Overall 1.560 5. Implications of long-term survivals in acute stem cell leukemia of childhood treated with composite cyclic therapy. There will be an estimated 8.470 Table 4: Source: Cancer Facts & Figures 2007.390 21. Cancer Statistics Review. LEUKEMIA LYMPHOMA MYELOMA page 9 .020 240 3. Hispanics with leukemia who are under the age of 25 had the highest mortality rates from the disease between 1990 and 1999.420 4. Blood. Despite this decline.680 12.710 9.970 250 2.500 8.940 3.500 deaths from CLL and 1. about 515 children under the age of 14 are expected to die from leukemia.Five-Year Relative Survival Rates for Acute Lymphocytic Leukemia.990 490 6. SEER (Surveillance. There will be an estimated 4. Zuelzer WW. Unclassified forms of leukemia will account for 6. 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. 1964:24:477-494. Sources: 1.320 males and 9. 2007. 1964-2003 90% 80% 70% 60% 58% 71% 66% 73% 78% 83% 84% 87% The estimated numbers of deaths attributed to leukemia in the United States are 30 percent higher for males than for females.990 deaths from AML and 490 deaths from CML. American Cancer Society. Epidemiology and End Results). Non-Hispanic whites diagnosed with leukemia over the age of 44 had the highest death rates during this period. In 2007. In 2007. 2. 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.790 deaths in the United States will be attributed to leukemia in 2007: 12. in Children Under 15 Years of Age.320 Female 600 1. deaths from leukemia are expected to be distributed in the following numbers: In 2007. Deaths It is anticipated that approximately 21. 1975-2004.790 Male 820 2.420 deaths from ALL. leukemia causes more deaths than any other cancer among children and young adults under age 20. National Cancer Institute. Estimated Deaths (All Age Groups) from All Types of Leukemia in 2007 Type Acute lymphocytic leukemia Chronic lymphocytic leukemia Acute myelogenous leukemia Chronic myelogenous leukemia Other.470 females. 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.
while 0. or low. Both Hodgkin and non-Hodgkin lymphomas are more common in males than in females. These risk factors explain only a small proportion of cases. the difference was small.266 members of the U.190 cases of Hodgkin lymphoma and 63. Lymphoma results when a lymphocyte (a type of white blood cell) undergoes a malignant change and begins to multiply. malignant cell found in Hodgkin lymphoma tissues). in general whites have higher incidence rates than blacks. and each has prognostic factors that categorize it as more or less favorable. Incidence by Gender Table 5 illustrates the breakdown of incidence of lymphoma by gender. After 50 to 54 years of age. there are 138.3 per 100. New Cases About 71. incidence rates for non. Living with Lymphoma In the United States in 2007. The bacterium Helicobacter pylori is associated with the development of lymphoma in the stomach wall. 2007.7 percent of all cases of non-Hodgkin lymphoma will be diagnosed in children under 15 years of age this year.S. American Cancer Society.9 per 100. intermediate and high grade. Persons infected with the human immunodeficiency virus (HIV) have a much higher risk of developing lymphoma. In 2004.190 63. population who are living with lymphoma.953 people living with nonHodgkin lymphoma for a total of 544. Fifty-three percent of the blood cancers diagnosed are lymphomas.000 for females. Each histologic grouping is diagnosed and treated differently. Age-specific incidence rates of non-Hodgkin lymphoma are 2.470 34.000 for males and 38. 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. The reasons for the development of non-Hodgkin lymphoma are not certain.720 28. Immune suppression plays a role in some patients.710 Total 8. New Cases of Lymphoma by Gender. an average annual percentage increase of 2. 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 rates for Hodgkin lymphoma tend to be higher among males than among females.8 percent.Hodgkin lymphoma are higher in Americans of European descent than among those of African descent.000 for females. eventually crowding out healthy cells and creating tumors that enlarge the lymph nodes or other sites in the body.670 Female 3. More than four percent of all cases of Hodgkin lymphoma diagnosed in 2007 will be in children under 15 years of age. The Epstein-Barr virus causes Burkitt’s lymphoma in Africa.6 per 100. The incidence of Hodgkin lymphoma is consistently lower than that of non-Hodgkin lymphoma. Hodgkin Lymphoma Hodgkin lymphoma is a specialized form of lymphoma and will represent about 11.990 32.190 cases of non-Hodgkin lymphoma).380 Americans will be diagnosed with lymphoma in 2007 (8.Lymphoma Lymphoma is a general term for a group of cancers that originates in the lymphatic system.190 71.200 38. rose by 84 percent from 1975 to 2004. Non-Hodgkin lymphoma is the fifth most common cancer in males and females in the United States. they are 52.000 at ages 20 to 24 for males and 1.380 Table 5: Source: Cancer Facts & Figures 2007. The groups are often classified as indolent or aggressive. LEUKEMIA page 10 LYMPHOMA MYELOMA . It is the sixth most common cause of cancer deaths in males and in females. 2007 Type Hodgkin lymphoma Non-Hodgkin lymphoma Total Male 4. By ages 60 to 64.313 people living with Hodgkin lymphoma (active disease or in remission) and 405.5 percent of all lymphomas diagnosed in 2007. Hodgkin lymphoma has characteristics that distinguish it from all other cancers of the lymphatic system.9 per 100. including the presence of an abnormal cell called the ReedSternberg cell (a large.
4 cases per 100. groin or in the abdomen. and more than 46-fold to 112. Hodgkin lymphoma incidence rates are higher in adolescents and young adults than in adults in their middle years. Treatment Hodgkin lymphoma is often treated with radiation and chemotherapy. In children from 0 to 19 years of age. It is rarest among American Indian/ Alaskan native children. localized non-Hodgkin lymphoma is sometimes treated with radiation. the highest incidence of non-Hodgkin lymphoma is in non-Hispanic whites. indigestion and abdominal pain. following leukemia (26.5 percent. chemotherapy or both may result in cures for most patients with Hodgkin lymphoma.8 percent for all races in 1996-2003. Non-Hodgkin lymphoma is the fifth most common cancer in Hispanics. and non-Hodgkin lymphoma.5 percent) are the third most common cancers in children. night sweats. Signs and Symptoms Signs and symptoms of Hodgkin lymphoma include painless swelling of lymph nodes in the neck. In children up to age 14 years. 3. followed closely by Hispanic children of all races (24. 1. The five-year relative survival rate for non-Hodgkin lymphoma patients has risen from 31 percent in whites in 1960-1963 to 63. Radiation. recurrent high fever. the highest incidence of non-Hodgkin lymphoma is in Asian/Pacific islanders. persistent fatigue. From ages 15 to 19. The incidence in this group decreased almost steadily and significantly between 1975 and 1999. armpit. The most common early sign of other forms of lymphoma is also painless swelling of the lymph nodes – usually in the neck. depending on the tumor size.000 children in 2004. Incidence in Adults The incidence of non-Hodgkin lymphoma increases with age. LEUKEMIA LYMPHOMA MYELOMA page 11 . Survival for Children Five-year relative survival is 95. loss of appetite and bone pain.8 percent) and neoplasms of the brain and other nervous tissue (17. 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. troublesome itching and weight loss. Lymphomas (Hodgkin lymphoma.to 24year-old individuals.730 persons will die from lymphoma in the United States in 2007 (18.000 persons at ages 80 to 84.5 percent. In children under 20 years of age. Symptoms also often include fever.070 from Hodgkin lymphoma). five-year relative survival for non-Hodgkin lymphoma is now 83. Adolescents are more commonly diagnosed with Hodgkin lymphoma than young children. Deaths An estimated 19. armpit or groin. cell type and location of the lymphoma. sweating at night. comprising nearly 5 percent of all cancers diagnosed. Non-Hodgkin lymphoma is the ninth most common cause of cancer death in males and the seventh in females in the United States.400 children under the age of 15 will be diagnosed with cancer in 2007. excessive tiredness.000 people occur in 20. lymphomas are most commonly diagnosed in whites (24.0/1 million population). widespread disease requires chemotherapy or chemotherapy and/or monoclonal antibody therapy with radiation.1 per 100.9 percent). The rate increases more than 18 times to 45.5/1 million population). In the United States.2 percent for Hodgkin lymphoma in people under 20 years of age. Survival for Adults Hodgkin lymphoma is now considered to be one of the most curable forms of cancer. about 10. Early stage. Incidence in Children The incidence of Hodgkin lymphoma among people under 20 years of age was 1. and is the eighth most common cause of cancer death in that group. Death rates have been declining for Hodgkin lymphoma patients since the mid-1970s.000 by ages 60 to 64. most children with nonHodgkin lymphoma did not live five years after diagnosis.1 cases per 100. This represents a significant improvement in the rate of recovery. Even in the mid-1970s.660 from non-Hodgkin lymphoma.1 cases per 100.Among women. Treatment for non-Hodgkin lymphoma sometimes includes vaccines and other forms of immunotherapy. About 2. Five-year relative survival is now 95 percent for Hodgkin lymphoma in children aged 0 to 14 years. It has remained fairly constant since 1999. Hispanics of all races have the second highest incidence rates of non-Hodgkin lymphoma after whites. 4.
9 3.070 18.5 10. American Cancer Society.1 63. Age-Specific Incidence Rates for Non-Hodgkin Lymphoma.0 45. 2007.660 19.060 9. 2007. 2000-2004 6 Incidence (per 100. National Cancer Institute.730 Male 770 9.9 7.4 2.1 3.1 0.8 4.0 0.000) 5 4 3 2 1 0 0. Epidemiology and End Results) Cancer Statistics Review 1975-2004.360 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 2007.3 <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.4 4. LEUKEMIA page 12 LYMPHOMA MYELOMA .2 4.370 Female 300 9.8 2.8 3.2 1. *<16 cases per time interval. Epidemiology and End Results) Cancer Statistics Review 1975-2004.1 3.1 0.9 4. National Cancer Institute.0 1.8 112.0 2.0 20 10 0 0.4 2.0 100.4 3.1 4. 2007. 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 1.3 4.Age-Specific Incidence Rates for Hodgkin Lymphoma. Table 6: Source: SEER (Surveillance.4 2.9 1.6 32.5 <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. Epidemiology and End Results) Cancer Statistics Review 1975-2004.4 80. 2007.000) 70 60 50 40 30 22.4 15. National Cancer Institute. 2000-2004 110 100 90 80 Incidence (per 100.6 0.0 3.600 10.4 2. * <16 cases for time interval.1 102.
4 35. but it is the most difficult blood cancer to treat successfully.5 3. the patient’s own stem cells are used (autologous stem cell infusion). Malignant plasma cells produce an abnormal protein called monoclonal immunoglobulin. has been increasing. (11. 2007. 1-4. In myeloma.4 33. Age-Specific Incidence Rates for Myeloma. but primarily in the bone marrow. and it rarely occurs in people under age 45. It grows continuously and forms masses of plasma cells.1 0. Total survival for white males.000).1 5. 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 mortality rate from myeloma for people of African descent is more than double the rate for whites (7. median age at death from multiple myeloma is 74. Figure 9: Source: SEER (Surveillance.2/100. From 2000 to 2004. Bortezomib has been approved for treating myeloma in patients who have had at least two prior therapies.940 women) new cases of myeloma will be diagnosed in the United States in 2007. Epidemiology and End Results) Cancer Statistics Review 1975-2004.000). Myeloma was the 10th most common cause of cancer deaths for women in 2000-2004. 2000-2004 Incidence (per 100. The highest rates are found in black men 80 to 84 years of age and older (105/100.000) of myeloma than those of European descent (5. • Americans of African descent have a much higher incidence rate. a B lymphocyte.000) 40 30 20 10 0 0-24 0. myeloma was the 10th most commonly diagnosed cancer among African-American men and women.0 37. The U. Patients may have anemia.424 people in the United States are living with myeloma.9 9.790 deaths from myeloma are anticipated this year. approximately double.3 0.960 men and 8. It is 71 for African-Americans. especially in the marrow. 15-19. At times. Fractures may occur as a result of the weakened bones.000) is 56 percent higher than for women (4.900 (10. LEUKEMIA LYMPHOMA MYELOMA page 13 .1/100. Thalidomide is approved by the FDA for use in treating newly diagnosed myeloma. especially. • The incidence rate in men (7/100.8 14. 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. Treatment Chemotherapy for myeloma has led to sustained remissions in some patients. Treatment may include intensive chemotherapy followed by stem cell transplantation to restore normal blood cell production.S. tire more easily and feel weak.5/100. New Cases An estimated 19. 5-9. the cell that forms plasma cells. destroying normal bone tissue. Deaths Approximately 10. • The median age at diagnosis is 70. 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 21. two or three drugs are used simultaneously. Recurrent infections may be an early sign of the disease.000). Approximately 3 percent of all cancer-related deaths among AfricanAmericans in 2000-2004 were from myeloma. a type of white blood cell found in many tissues of the body.5/100. becomes malignant. causing pain and crowding out normal blood cell production. 10-14.000 to 3. 20-24). Usually. National Cancer Institute. Lenalidomide is approved by the FDA in combination with dexamethasone for the treatment of myeloma patients who have received at least one prior therapy.000) for all racial and ethnic groups.1 28.3/100. 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. • The median age at diagnosis for African-Americans is 67. Treatment is aimed at slowing progress of the disease.1 Signs and Symptoms Often the first symptom of myeloma is bone pain caused by the effects of myeloma cells in the marrow.7 1. Sixty percent of those were diagnosed with the disease within the past four years. Living with Myeloma An estimated 60. *<16 cases for each age interval. SEER 17 areas (<1.
the most recent available. Epidemiology and End Results) Cancer Statistics Review 1975-2004. National Cancer Institute.6 2.2 3.7 5.9 2.1 9.0 Female 8. All Races. 2007. per 100. National Cancer Institute.000 Population (2000-2004) Type Leukemia Non-Hodgkin lymphoma Hodgkin lymphoma Myeloma Overall 12.3 2.2 2. Epidemiology and End Results) Cancer Statistics Review 1975-2004.5 Incidence Rates by Gender.4 11.7 24.1 Table 10: Source: SEER (Surveillance.3 Male 13.6 4. per 100. National Cancer Institute.000 Population (2000-2004) Type Leukemia Non-Hodgkin lymphoma Hodgkin lymphoma Myeloma Overall 10.0 Female 9.2 14. 2007.000 Population (2000-2004) Type Leukemia Non-Hodgkin lymphoma Hodgkin lymphoma Myeloma Overall 12.2 Male 16.3 19. Lymphoma and Myeloma The following tables showing incidence rates for leukemia. 2007.0 23.8 14.8 20. Rates are per 100.Incidence Rates: Leukemia.5 Table 8: Source: SEER (Surveillance.4 4.2 18.000 population and are age-adjusted to the 2000 population.6 Female 9. (Based on SEER 17 areas.0 2.6 Male 16.) LEUKEMIA page 14 LYMPHOMA MYELOMA . Hodgkin and non-Hodgkin lymphoma and myeloma use figures from 2000-2004. for Whites.2 6.1 2.) Incidence Rates by Gender. Epidemiology and End Results) Cancer Statistics Review 1975-2004.0 7.3 2.5 16. per 100.1 3. (Based on SEER 17 areas.9 17.9 5.1 11. (Based on SEER 17 areas. for Blacks. Incidence Rates by Gender.) Table 9: Source: SEER (Surveillance.
550 * * * * *20 * * * * 60 * * * 50 * * * * * * * * * * * * * * * * * * 70 * * 50 * * 60 * * * * 80 * * * * * * * 390 Table 11: Sources: Cancer Facts & Figures 2007.240 170 550 130 800 3.370 250 280 2.510 500 60 70 900 380 220 160 280 430 100 370 460 730 310 170 400 70 110 120 80 650 120 1..550 2. **State estimates may not add up to U. **State estimates may not add up to U.630 540 80 120 990 510 310 230 320 330 100 390 490 770 400 210 460 80 150 160 100 680 120 1. 2007.S. Numbers are rounded to the nearest 10.680 920 340 890 170 290 330 190 1.190 880 870 170 100 4. total because of rounding and exclusion of estimates that are fewer than 50 cases.Estimated New Cases of Blood Cancers by Site.190 290 * 280 200 1.130 300 80 900 960 300 1.030 910 620 420 680 680 250 630 1.070 110 1. and additional data supplied by the American Cancer Society based on data from the U. Table 12: Sources: Cancer Facts & Figures 2007. They cannot be compared with previous years’ estimates to determine cancer incidence trends.300 470 90 100 750 430 300 220 290 310 110 320 420 660 350 170 500 80 110 130 90 600 120 1.520 310 3. Used with permission.330 260 780 180 1.610 150 2.180 4.710 570 500 2. LEUKEMIA LYMPHOMA MYELOMA page 15 . and additional data supplied by the American Cancer Society. numbers are small and NCI and ACS are having difficulty fitting them into the Pickle et al.790 330 * 320 200 1. by State.200 350 4.150 290 270 70 * 1. American Cancer Society. January/February 2007.S.560 770 890 3.540 1.500 430 1.140 60 260 80 410 1.170 480 1. *Estimate is fewer than 50 cases. 2007 State Leukemia Non-Hodgkin Lymphoma Myeloma Hodgkin Lymphoma Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Dist.010 1.370 100 * 430 380 130 350 * 19. 1969-2004.050 140 140 * * 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. Note: These estimates are offered as a rough guide and should be interpreted with caution.080 600 7. 2007.140 380 140 1. 2007 State Leukemia Non-Hodgkin Lymphoma Myeloma Hodgkin Lymphoma*** Estimated Deaths from Blood Cancers by Site.040 70 44. Note: These estimates are offered as a rough guide and should be interpreted with caution.390 1.360 610 * 950 290 260 1.260 220 400 420 290 2. The method of derivation. is described by Pickle et al.660 210 * 190 120 1. by State.160 1. Mortality Public Use Data Tapes.250 1. National Center for Health Statistics. *Estimate is fewer than 50 cases.410 560 * 740 230 230 930 70 300 50 350 1.030 570 * 610 210 360 1. which is new for 2007.080 1.160 140 50 360 440 170 320 * 18. 2006.410 130 50 500 490 130 490 * 21.240 740 80 1.670 1. Centers for Disease Control and Prevention. ***Hodgkin lymphoma estimates are not available for 2007.S.880 240 250 50 50 1. model (see below).070 Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Dist.360 960 170 220 2.610 670 610 110 60 3.530 1.310 800 600 900 920 330 1. Numbers are rounded to the nearest 10.070 80 330 70 480 1.300 110 63. Used with permission. total because of rounding and exclusion of estimates that are fewer than 50 cases. CA A Cancer Journal for Clinicians. 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. American Cancer Society.830 240 230 60 * 1. 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.
may be incomplete in some cases and the data may reflect adjustments that anticipate changes that will occur once the actual data are received.S. 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. The specified date is 1/1/2004 for the prevalence estimates. Because of reporting delays from some of the SEER regions. the data presented in the 2007 SEER report placed online on April 15.” We are using the “29-year limited duration” prevalence figures. so the exact number of cases is not known. mostly upward. This year.. The data can be extrapolated for the entire United States by multiplying by the population ratio. if a person is initially diagnosed with melanoma and later develops leukemia. When expressed as a rate. no matter how long ago that diagnosis was. Thus. (Observed survival is the actual percentage of patients still alive at some specified time after diagnosis of cancer. 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. population) that belong to the National Program of Cancer Registries. 2007. It considers deaths from all causes. in comparison to the 2002 SEER report. CA A Cancer Journal for Clinicians. only the first diagnosed cancer counts. Epidemiology and End Results Program (SEER) regions (or.S. Definitions Incidence is the number of newly diagnosed cases for a specific cancer or for all cancers combined during a specific time period. LEUKEMIA page 16 LYMPHOMA MYELOMA . It includes new (incidence) and preexisting cases and is a function of both past incidence and survival. in some cases fewer than 17 SEER regions) and death data from the National Center for Health Statistics. but these figures do not take into account differences in geography.S. based on the “first invasive tumor for each cancer site diagnosed during the previous 29 years (1975-2003). This change means that the 2007 incidence estimates are not comparable with previous estimates for determining cancer incidence trends. race or sex. state-by-state data for incidence of Hodgkin lymphoma are not available because these numbers are so small. it is the number of new cases per standard unit of population during the time period. population.S. 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. survival and mortality have been revised. cancer or otherwise. The relative survival rate is a comparison of survival to a person who is free of the disease. Census. The description of the methods used was published in Pickle et al. 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.” as per SEER table I-21. The American Cancer Society projects this year’s estimated cancer cases and deaths based on incidence rates for 1995 to 2003 from 41 states (approximately 86 percent of the estimated U. The data presented in this report are an extrapolation or estimate of the number of cases reported by the 17 Surveillance. especially in looking at populations in which individuals have had more than one type of cancer. Prevalence may be calculated in a number of different ways. This rate is calculated by adjusting the observed survival rate so that the effects of causes of death other than those related to the cancer in question are removed. In this report. Bureau of the Census’ 2000 population data for that region.) Prevalence is the estimated number of people alive on a certain date in a population who previously had a diagnosis 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. Because of this change in method. the American Cancer Society changed its method of estimating cancer incidence. estimates of cancer incidence.Notes and Definitions Notes The United States does not have a nationwide reporting system or registry for blood cancers. Incidence rates can be calculated based on a number of factors such as age. prevalence numbers reported may vary depending upon the method used to determine them. The SEER (17 region) data cover only about 26 percent of the U. Thus. January/February 2007. In some prevalence statistics. race and ethnicity in various regions and region-specific health risks.
065767. Atlanta: American Cancer Society. based on November 2006 SEER data submission. Miller BA. 2006. 065767. NIH Pub. “Highlights and Challenges. Tiwari RC. Bethesda. Ries LAG (eds). 2007. 30-42. In Cancer Epidemiology in Older Adolescents and Young Adults 15 to 29 Years of Age.” Hayat MJ.com/cgi/content/full/12/1/20. Including SEER Incidence and Survival: 1975-2000. posted to the SEER Web site 2007. Horner MJ. and Multiple Primary Cancer Analyses from the Surveillance. Zou Z. National Cancer Institute. The Oncologist Vol. 2006. No. 06-5767. National Cancer Institute. Bleyer A.” O’Leary M. SEER (Surveillance. MD. Ward E.” Mattano L Jr. In Cancer Epidemiology in Older Adolescents and Young Adults 15 to 29 Years of Age. Epidemiology. Barr R. MD. “Leukemias.TheOncologist. pp. 1975-2004. In Cancer Epidemiology in Older Adolescents and Young Adults 15 to 29 Years of Age. January/February. Keller F. O’Leary M. Including SEER Incidence and Survival: 1975-2000. http://caonline. MD. 39-51. Epidemiology.” Bleyer A. Atlanta: American Cancer Society. Reichman ME. pp. Melbert D. NIH Pub. 12. CA A Cancer Journal for Clinicians Vol. O’Leary M. Mariotto A. Ries LAG (eds). Bleyer A. Bleyer A. 20-37. http://seer. Feuer EJ.gov/csr/1975_2004/ LEUKEMIA LYMPHOMA MYELOMA page 17 . Nachman J. Eisner MP. 2007. 174. Bethesda. Barr R. MD. Edwards BK (eds). Stock W. 2007. and End Results (SEER) Program. O’Leary M. Cancer Facts & Figures for African Americans 2007-2008. National Cancer Institute. Howlader N. “Lymphomas and Reticuloendothelial Neoplasms.cancer. January. Cheson B. Feuer EJ. Reichman M. Ross J.” Pickle LW. Clegg L. Bethesda. “Cancer Statistics. National Cancer Institute.Citations Source Citations Cancer Facts & Figures 2007. “A New Method of Estimating United States and State-Level Cancer Incidence Counts for the Current Calendar Year. Including SEER Incidence and Survival: 1975-2000. Barr R. Krapcho M. No. pp. Hachey M.amcancersoc. NIH Pub. Howe HL. Sheaffer J. pp. No. http://www. 2006. Jemal A. Trends. Barr R. 57. Edwards BK.org/cgi/content/full/57/1/30. Howlander N. Ries LAG (eds). Ries LAG. p. and End Results) Cancer Statistics Review. Shu X-O. Hao Y. 25-38. 2007. Bethesda.
000 over five years. Research Research Grant Programs The Society’s research programs are based on the belief that all scientifically sound approaches toward a cure for.000. to a total cost of $6. are granted each year. research reaching a clinical trial can receive $1 million over five years to facilitate new drug discovery or advances in diagnosis or prevention. The SCOR grants also support scientific core laboratories to provide access to innovative technology if required by the participating research programs.6 million annually on research. Career Development Program The Career Development Program supports promising young scientists (Scholars.000 over three years. lymphoma and myeloma that is intended to advance treatment. 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. The Grant Review Process Scientists and physician-scientists who are experts in the field of leukemia. leukemia. Each SCOR is funded up to $1. Since the first funding in 1954. or control of. They are: 1) Career Development Program (CDP)-basic research. Thus.000 a year for a total of $180. 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’s grant programs are among the most prestigious in the fields of blood cancers. and improve the quality of life of patients and their families. lymphoma or myeloma. treatment or prevention of leukemia. The Specialized Center of Research (SCOR) in Leukemia. Funding for two additional years may be provided for highly promising projects that are entering phase I clinical trial. Translational Research Program The Translational Research Program provides early-stage support for research on leukemia.000 over three years. The program is expected to generate new knowledge and breakthrough discoveries. Research grants are awarded in three program areas: Career Development. lymphoma and myeloma research comprise four review subcomittees. Translational Research Awards are made for an initial three-year period.000 over three years. Hodgkin’s disease and myeloma. We offer a wide variety of programs and services in support of our mission: Cure leukemia.000 per year for three years. Translational Research and the Specialized Center of Research (SCOR). Translational Research • Scholars in Clinical Research are awarded $110. lymphoma and myeloma should be encouraged worldwide. Awards go to those groups that best demonstrate the synergy that will occur from their close interaction. for a total of $600.25 million. diagnosis or prevention in the near term.000 a year for a total of $150. • Fellows are awarded $50. lymphoma and myeloma. 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. • Special Fellows in Clinical Research are awarded $60.000 a year for a total of $180.25 million per year over a five-year period. the Society has awarded more than $550 million in research grants. each focused on the discovery of new approaches to benefit patients or those at risk for developing leukemia.000 a year for a total of $550. The Society is a nonprofit organization that relies on the generosity of individual and corporate contributions to advance its mission. • Special Fellows are awarded $60. Awards up to $200. Now supporting $61. 3) Translational Research Program.000 over five years. lymphoma. The participating scientists may be at different institutions or from any country. leading to better survival rates and prevention measures for patients.000 a year for a total of $550. 4) Specialized Center of Research Program that evaluate all grant applications in those programs and determine those applicants with the most innovative and LEUKEMIA page 18 LYMPHOMA MYELOMA .
lymphoma and myeloma. The Society also hosts numerous teleconferences and Webcasts. The IRC is a worldwide link to information and resources useful to patients. clinical trials and offer guidance on coping.LLS. Educational Materials An extensive collection of free educational materials are offered to patients and health professionals.LLS. and click “Live Help. instructions. serves a wide variety of education and information needs. LEUKEMIA LYMPHOMA MYELOMA page 19 .m. Guided by two volunteer oncology health professionals. podcasts and Webcast archives of these programs are available at www. is held each December on the Friday immediately before the American Society of Hematology meeting. Professional Education The Society serves the continuing educational needs of the medical and research community through professional symposia offered throughout the year. Co-Pay Assistance Program Patients with AML. brochures and videos through the IRC and local Society chapters. These offices conduct lifeenhancing patient services. The user has the opportunity to create personalized pages with identified interests.important projects to advance the Society’s mission. Information specialists are oncology social workers and health educators who provide callers with current information on blood cancers. First Connection: This program links newly diagnosed patients to a peer volunteer who has experienced a similar diagnosis. The Society’s Web Site The Society’s Web site. call (877) LLS-COPAY ( 557-2672) or email copay@LLS.org. Information on registration for these free events can be accessed at www. This support should advance the understanding. The Annual Research Symposium.org. Patient Services The Society has a network of 68 chapters throughout the United States and Canada. Patients. The site features a comprehensive overview of blood cancers.m.org/copay. the Society distributes more than 1 million booklets. Family Support Group locations. on the Society’s Web site.m. www. www. ET. 9 a.org.LLS. the Translational Research Grant Progress Review Meeting and the SCOR Progress Review Meeting.LLS.LLS. Teleconferences and Webcasts The Society sponsors more than 25 educational teleconferences and Webcasts each year on topics of interest to patients and caregivers. Other meetings are held for the Society’s grantees. and applications for the Society’s three research programs may be obtained by visiting www.org or by or emailing researchprograms@LLS. friends and healthcare professionals. to 5:00 p.” Chapter Programs: Family Support Groups: The Society has developed more than 360 Family Support Groups at 68 chapters. The Society funds several Focused Workshops each year on important topics relevant to hematological malignancies. www.org or faxing to (914) 949-6691 or contacting the Research Department at (914) 949-5213. Much of the content of these materials is available to view and download at www. Each year. It is continually being updated and expanded to support and promote the Society’s mission.LLS. You may also chat online with an information specialist. treatments.org. Guidelines. They are available to talk one-onone. The educational program offers varying formats to facilitate the exchange of information and ideas on the newest developments in cancer research and treatment. Information Resource Center (IRC) The Society strives to be the world’s foremost source of information on leukemia. their families and healthcare professionals. myeloma. peer counseling and patient financial aid. As of June 30.org. and encourages greater communication among patients. information about our peer-to-peer program First Connection and other programs. 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. each group provides information and support. 2007 the Society will have 379 active grantees at 116 institutions in the United States and abroad. These include the Stohlman Scholar Symposium. A trained patient volunteer currently in remission phones the new patient to share information and support. audio.m. treatment and prevention of leukemia. Monday through Friday.LLS. ET.org. to 6 p. families and professionals may call the IRC toll free at (800) 955-4572 in addition to corresponding by email at infocenter@LLS. families. where medical professionals share the latest research findings. the Society’s programs and services. from 10:00 a. Patients needing assistance may apply on the Society’s Web site. myelodysplastic syndromes (MDS) and other blood cancers.org. including support groups. lymphoma. sponsored by the Society. lymphoma.
In 2001. This nursing education program provides an overview of CML. Welcome Back: Facilitating the Return to School for Children with Cancer: A new addition to The Trish Greene Back to School Program. Meet the Expert on Non-Hodgkin Lymphoma: This program presents basic information on terminology. emerging therapies and side effects and addresses the unique challenges of nursing management of these patients. CML Issues and Insights: A Nursing Education Program on Chronic Myelogenous Leukemia. In 2002. 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. Through the Patient Financial Aid Program. the Society successfully lobbied Congress to institute a blood cancer research initiative as part of the U. Advocacy Since 1994. patients and school personnel to assure youngsters a smooth transition from active treatment back to school. DC. 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 program is being sponsored by an unrestricted education grant from Novartis Oncology. that program has funded some $30 million in additional blood cancer research. Patient financial aid funds are subject to availability. The Path to Progress: Clinical Trials in Blood Cancers: This program provides patients. LEUKEMIA page 20 LYMPHOMA MYELOMA . New insights. Working through chapters across the country. the Society’s advocacy program has been a strong voice in Washington.Patient Financial Aid Program: For more than 31 years. To date. lymphoma and myeloma. 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. and offers numerous resources that can assist childhood cancer survivors to flourish in the school environment posttreatment. Printed literature. This program is made possible by the Lance Armstrong Foundation. The Society has identified key issues that currently shape its advocacy agenda. This program is also accessible as a Webcast at www. providing additional support for blood cancer patients and their families nationwide.LLS. families and healthcare professionals with a clear description of what clinical trials are. diagnosis. Society volunteers and staff visit Capitol Hill regularly to lobby Congress in support of issues that impact research and patient care. the Society has helped patients demonstrating a need for financial assistance cover a portion of their treatment costs. how cancer drugs are developed and what the emerging treatment options are for leukemia. treatments. reimbursement of up to $500 per year helps cover the costs of transportation. the Society has successfully ensured coverage of routine care in cancer clinical trials in three states and secured additional funding for patient support programs in four others. The patient education program was funded at $18 million through 2007. Department of Defense’s medical research program. staging and classification of nonHodgkin lymphoma (NHL). treatments and future directions for NHL are also discussed. representing to policy makers at all levels of government the healthcare quality concerns and medical research interests of patients and their families. parents. unrestricted educational grant from Genentech BioOncology and Biogen Idec Inc.org and is being sponsored by a generous. That network now numbers more than 35. The Trish Greene Back to School Program for Children with Cancer: This program is designed to increase communication among healthcare professionals. treatments. New Directions in Myeloma Therapy: This program presents an overview of myeloma. 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. On the state level.and long-term effects that children may experience after treatment.S. this education program discusses possible emotional and cognitive short.000 and has become a potent voice in public policy deliberations. This Society program is being supported by Celgene Corporation and Millennium Pharmaceuticals. videos and other materials to aid the process are available through all local chapters. emerging therapies and managing side effects and how to find emotional support when living with the illness. drugs and various treatments not covered by insurance. This program is provided through an unrestricted educational grant from Millennium Pharmaceuticals. It is supported by Amgen Oncology. risk factors.
. provided ACS’s state-by-state statistics on myeloma and Hodgkin lymphoma. of the American Cancer Society (ACS).Acknowledgements Additional data from SEER*Stat Databases at http://www. The Leukemia & Lymphoma Society extends special thanks to Myrna Watanabe. This publication is designed to provide information in regard to the subject matter covered.D. It is distributed as a public service by The Leukemia & Lymphoma Society Inc.seer. Milton Eisner of SEER. with the understanding that the Society is not engaged in rendering medical or other professional services. for compilation of data for this publication. and Rebecca Siegel. Ph.cancer. provided statistical assistance. NCI..gov.
Suite 310 White Plains.HELP.LLS.LLS Information Resource Center (IRC): 800. lymphoma. The Society is a nonprofit organization that relies on the generosity of individual. Hodgkin’s disease and myeloma. New York 10605 Tel: 888.4572 www. PS80 35M 6/07 .955. corporate and foundation contributions to advance its mission.Home Office 1311 Mamaroneck Avenue.org Our mission: Cure leukemia. and improve the quality of life of patients and their families.
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