Facts 2007-2008

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

L eukemia
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

10 Lymphoma

Tables
6
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

13 Myeloma

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

LEUKEMIA

LYMPHOMA

MYELOMA

Cover Photo: Light microscopy (Magnification = 700x) of a human lymphoma cell. Credit: Dr. Cecil H. Fox/Photo Researchers, Inc.

Myeloma: • • • • There are 60. 19. • These blood cancers will account for 9. • In 2007.920 new cancer cases diagnosed in the United States this year. www.444. the incidence of myeloma increased 8 percent. Survival • An estimated 823. 71. • This year.3 percent of the deaths from cancer in 2007 based on the 559. 2007 and SEER 19731993. Hodgkin and non-Hodgkin lymphoma and myeloma will account for nearly 9. and its age-adjusted incidence rose by nearly 84 percent from 1975 to 2004.349 Americans are living with leukemia. The next SEER Cancer Statistics Review is expected to be published online in April 2008. 10. 19.Executive Summary Facts 2007-2008.900 people will be diagnosed with myeloma.gov. National Cancer Institute.380 new cases of lymphoma will be diagnosed in the United States (8. Hodgkin and non-Hodgkin lymphoma. someone dies from a blood cancer. page 16). • New cases of leukemia. • Every five minutes. 1996. The data within Facts 2007-2008 reflect the most recent statistics available from SEER. 21.190 cases of Hodgkin. 1998. More males are diagnosed with leukemia and more males die of it than females. Leukemia.266 people living today with lymphoma. This year. which becomes malignant and multiplies continuously. Cancer Statistics Review 1975-2004 (see Notes.4 percent of the 1.790 people will die of leukemia. 63. is a compilation of the most recent data on leukemia. 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. Oxford University Press. 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.650 total cancer-related deaths. or nearly six people every hour.310 people in the United States this year. lymphoma and myeloma. • Every 10 minutes.313 either have or are in remission from Hodgkin lymphoma. • Non-Hodgkin lymphoma is the fifth most common cancer in the United States. LEUKEMIA LYMPHOMA MYELOMA page 1 . From 1975 to 2004. This year. 44. • In general.cancer.424 people living today with myeloma. the National Cancer Institute’s Surveillance. 18. nonacute myelogenous and monocytic leukemias Lymphoma: • There are 544. lymphoma and myeloma will cause the deaths of an estimated 52.1975-1977 vs. Epidemiology and End Results Program. This abnormal accumulation interferes with the production of healthy blood cells. and myeloma. an annual publication. 138. These data were published online by SEER.seer.790 people will die from myeloma. • Eighty-six percent of myeloma cases occur in people aged 55 and over. • This year.660 from non-Hodgkin).070 from Hodgkin.953 either have or are in remission from non-Hodgkin lymphoma (NHL). *Myeloma Biology and Management. the likelihood of dying from most leukemias*. • Thirty-two percent more males are living with leukemia than females. • Leukemia causes more deaths than any other cancer among children and young adults under the age of 20.520 people in the United States will be diagnosed with leukemia.659 people in the United States who are either living with or are in remission from leukemia. Deaths • Leukemia. • In 2007. This statistic represents 143 people each day. *except acute myelogenous leukemia (AML) and other.730 people will die from lymphoma (1. Highlights from the Report Include: New Cases • An estimated 135. in April 2007.190 cases of non-Hodgkin). someone is diagnosed with a blood cancer.240 people will be diagnosed with leukemia. 1960-1963 1975-1977 1996-2003 Figure 1: Sources: SEER (Surveillance. Five-Year Relative Survival Rates 1960-1963 vs. Epidemiology and End Results) Cancer Statistics Review. lymphoma and myeloma in 2007. National Cancer Institute. lymphoma and myeloma decreased from 1995 to 2004 (the last year data were available). 1975-2004. 405. Mortality from the disease increased 24 percent. 2nd Edition.

especially for children. 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. slightly mismatched cord stem cell donors may be used quite successfully. freezing and storing of cord blood have provided another source of stem cells for transplantation. 2007. 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. lymphoma and myeloma. 2007. (Numbers do not add up to 100% because of rounding. These diseases usually result from an acquired genetic injury to the DNA of a single cell. American Cancer Society. studies suggest that two matched cord donors may result in a higher success rate in larger adults. However.About the Diseases Leukemia. a search of the National Marrow Donor Program registry of tissue-typed volunteers could be made for a matched unrelated donor. Approximately 50 different drugs are now being used in the treatment of these diseases. Stem cells also circulate in large numbers in fetal blood and can be recovered from umbilical cord and placental blood after childbirth. The harvesting. large localized areas of nonHodgkin lymphoma or with special complications that are amenable to radiation therapy may receive both primary chemotherapy and ancillary radiation therapy. The numbers of stem cells in cord blood are often insufficient for the needs Figure 2: Source: Cancer Facts & Figures. In special instances. Research is being conducted to improve socalled “haploidentical” transplant. Hodgkin and non-Hodgkin lymphoma and myeloma are cancers that originate in a cell in the bone marrow or lymphatic tissues. usually a brother or sister with the same tissue type. Patients with acute lymphocytic leukemia (ALL). The accumulation of malignant cells interferes with the body’s production of normal blood or immune cells and can result in severe anemia. Cord blood stem cell transplantation provides an additional donor pool and the opportunity for greater ethnic diversity in the blood supply because of collection efforts in hospitals where children of underrepresented ethnic backgrounds are born. especially in young children. Patients with leukemia. An allogeneic transplant uses blood or marrow stem cells from a normal donor. Such an approach would greatly lessen the proportion of children without a 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).) of larger adult patients. for which a parent rather than a sibling could be the donor. Autologous transplantation uses the patient’s own marrow stem cells and is technically not transplantation since another person is not the donor. myeloma and lymphoma are usually treated with chemotherapy. Syngeneic transplant describes the use of an identical twin as donor. If a sibling is not available. decreased ability to fight infections and a predisposition to bleeding. which becomes abnormal (malignant) and multiplies continuously. The technique of harvesting stem cells from blood and cord blood has made transplantation available for more LEUKEMIA page 2 LYMPHOMA MYELOMA . There are two major types of stem cell transplants: syngeneic and allogeneic. The technique is important. 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. some types of Hodgkin lymphoma. is largely responsible for the dramatic improvement in managing leukemia and lymphoma. usually in combinations of two or more drugs. The blood or marrow stem cells are collected while the patient is in remission.

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. as well as marrow. “Nonablative” allogeneic stem cell transplantation is the term applied to a technique of allogeneic transplant that uses lower doses of chemotherapy and/or radiotherapy to prepare the recipient for the donor’s stem cells. The 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. It works by blocking the oncogeneencoded protein product that instigates the transformation to a leukemic cell. Gleevec offers several dramatic advantages to patients: oral administration. two second-generation agents. Coordination between specialists and primary care physicians is essential to provide the best care possible. decreased side effects. marrow and immune system. In nonablative transplantation. frozen and stored and later transplanted in the patient.org/).patients. making the procedure more tolerable. Some treatment centers have follow-up clinics that provide a comprehensive. several important new drugs and new uses for existing drugs have greatly improved cure rates or remission duration for some patients with leukemia. This still experimental approach greatly lessens the early toxicity of transplantation and has extended the age at which recipients 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. Follow-Up Care Regular medical follow-up enables doctors to assess the full effect of therapy. Identifying these biomarkers will allow researchers to develop tests that can predict what effects an individual is at risk of developing. Cancer survivors should see their primary care physicians for general health examinations and an oncologist for follow-up care related to cancer. Imatinib mesylate (Gleevec®) is now the drug of choice in newly diagnosed patients with chronic myelogenous leukemia (CML). Follow-Up Guidelines: The Children’s Oncology Group has established Long-Term Follow-Up Guidelines for Survivors of Childhood. the recipient’s blood cell and immune system are preserved. lymphoma or myeloma and permit the donor’s cells to be accepted by the temporarily immunodeficient recipient. Cancer survivors should have physical examinations yearly or more often. To ensure there will be enough blood stem cells for successful transplantation. as needed. Stem cells not only reside in the marrow but also circulate in the blood. lymphoma and myeloma. but some follow adult cancer survivors. identify recurrence of the disease and detect long-term or late effects. Although a minority of patients have developed resistance to the drug. or genetic factors that can increase susceptibility to certain effects. multi-disciplinary approach to monitoring and supporting cancer survivors. Because blood. This “graft versus leukemia or lymphoma effect” can suppress (cure) the malignancy and is a prolonged (indefinite) form of immunotherapy. “Ablation” referred to wipingout the recipient’s cancer. lymphoma or myeloma can have an allogeneic transplant. is a source of stem cells for transplantation. New Approaches to Treatment Several areas of research have resulted in new approaches to the treatment of leukemia. Most follow-up clinics specialize in pediatric cancer survivors. Biomarkers could be high levels of certain substances in the body such as antibodies or hormones.childrensoncologygroup. 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. thereby allowing doctors to plan treatment accordingly. lymphoma or myeloma is attacked and suppressed by donor lymphocytes that form from the donor stem cells. Adolescent. ablation of the recipient’s blood-cell forming and immune cells was the price that had to be paid to eradicate the leukemia. Cancers (http://www. the donor’s cells take hold and the patient’s leukemia. donors of blood stem cells require special treatment to mobilize sufficient stem cells from marrow into their blood before cells are harvested. Regular examinations may include screening for cancer recurrence or the development of secondary cancer or other late effects of treatment. In standard stem cell transplantation. these cells can be harvested from the blood of a donor. Development of New Drugs: In the past decade. Blood and cord blood transplants differ from marrow transplants principally in the source of the cells collected for transplant. few severe adverse effects on normal tissues and a very high response rate. Over time. and Young Adult LEUKEMIA LYMPHOMA MYELOMA page 3 . The protein is an enzyme in the family of tyrosine kinases.

but it can also induce remissions in some cases of acute leukemia. Pentostatin is another effective drug that can be used in patients with hairy cell leukemia who do not respond to cladribine. are entering clinical use and can overcome this resistance in some cases. Alemtuzumab (Campath®) is a monoclonal antibody directed against the antigen CD52 found on T and B lymphocytes. and Decitabine (Dacogen®). In patients with anemia. The treatment of hairy cell leukemia. PDGFR or KIT oncoproteins). Food and Drug Administration [FDA] in 2006) and nilotinib (in clinical trials). Indeed. but without this specific chromosome 5 abnormality. was approved by the FDA for newly diagnosed myeloma. suppresses the progression of leukemia. In May 2006. Cladribine induces long-term remissions in nearly 90 percent of patients treated at diagnosis for one week. Immunotherapy: This is a treatment that uses immune cells or antibodies to fight the disease. 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®). Clofarabine (Clolar®). This drug is also being tested in clinical trials to treat adult acute leukemia and MDS. Other therapies in clinical research to treat MDS include arsenic trixoxide. Monoclonal antibodies have added to the arsenal of agents that are used for the treatment of patients with lymphoma and leukemia. principally. cyclophosphamide. 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. lymphoma or myeloma. a less common type of chronic lymphocytic leukemia (CLL). Three types of immunotherapy are being explored: antibody treatment. however. 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. immune cell administration and vaccine development. chronic eosinophilic leukemia (formerly hypereosinophilic syndrome). Monoclonal Antibody Therapy: Monoclonal antibodies are laboratory-produced proteins that can be infused into an appropriate patient. and enhances the specificity of treatment to minimize toxic effects on normal tissues. farnesyl transferase inhibitors and reduced-intensity stem cell transplantation. Gleevec is not only a very important new agent in the treatment of CML. Arsenic trioxide also adds to the drugs available to treat this subtype of acute leukemia. Velcade is approved by the FDA for treating people with myeloma who have had at least one prior therapy. 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. thalidomide (Thalomid®). the most prevalent lymphoma subtype. 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). LEUKEMIA page 4 LYMPHOMA MYELOMA . kill unhealthy bone marrow cells and may help the bone marrow function more normally in MDS patients. Lenalidomide (Revlimid®). Revlimid is approved by the FDA in combination with dexamethasone for the treatment of myeloma patients who have received at least one prior therapy.dasatinib (Sprycel®)(approved by the U. Azacitidine (Vidaza®). 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. Cell surface antigens have been given a cluster designation (CD) followed by a number. Patients with more severe forms of MDS are very unlikely to respond to the agent. has improved dramatically with the introduction of cladribine. approved by the FDA in 2005. vincristine (Oncovin®) and prednisone–therapy for diffuse large B-cell lymphoma. symptomatic anemia have improvement in hemoglobin levels with this agent. is being used to treat relapsed or refractory acute lymphocytic leukemia (ALL) in children who have received at least two prior therapies. a thalidomide derivative. reducing the need for transfusions in some patients. such as follicular lymphoma. it has now become an important fifth drug in the R-CHOP–rituximab. Rituximab is an antibody directed at the target CD20 antigen on B-cell lymphoma cells. doxorubicin (Adriamycin®). in combination with dexamethasone. perhaps 20 percent of cases also derive benefit. Early studies indicate the combination of arsenic trioxide and all-trans retinoic acid may be a further advance in the initiation of therapy. approved by the FDA for all types of MDS. although initially used in indolent lymphomas. Some patients with moderately severe. It is especially active against the lymphocytes in CLL. Rituximab has become an important agent to treat CD20-positive lymphocytic malignancies. thus rituximab is an anti-CD20 antibody.S.

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. 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. Examples of this treatment are the drugs ibritumomab (Zevalin®) and tositumomab and iodine I131 tositumomab (Bexxar®). gemtuzumab (Mylotarg®). In some approaches. In studies of CML. Monoclonal antibodies can also be linked to a radioactive isotope to target and kill specific cancer cells. some vaccines are made from leukemic cells treated in test tubes to convert them to potent antigen-presenting cells. lymphoma or myeloma cells. These drugs have been approved to treat relapsed B-cell non-Hodgkin lymphoma. 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. LEUKEMIA LYMPHOMA MYELOMA page 5 . Two new and potentially important approaches include a) the application of RNA interference. Paradoxically. the patient’s immune cells would be treated in the laboratory to train them to attack the residual leukemia. 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. Approaches to reversing multidrug resistance are under study. In one approach. Vaccines: Experimental treatment vaccines are now being studied to treat certain types of lymphoma. 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. If the gene in the former case is an oncogene or the protein in the latter case is an oncoprotein. These cells are. An alternative strategy called molecular targeted drug development targets the oncoprotein. The goal of several new agents being studied is to decrease resistance to an important chemotherapy drug used in leukemia. drugs are designed to interfere with the oncoprotein and prevent its effect on the cell. b) a modality that uses molecules of RNA to silence complementary (DNA) genes. lymphoma and myeloma. less responsive to therapy. These are called conjugated monoclonal antibodies. DNA vaccines that contain the DNA that encodes the specific antigen are being tested. a technique that prepares small molecules in the laboratory that have the ability to inactivate proteins that cause disease. cells are isolated in the laboratory and start making antibodies after insertion of the cancer antigen. Some vaccines contain antigens or parts of antigens purified from cancer cells obtained from the patient or from the same type of cancer cells but obtained from another patient. Reversal of Multidrug Resistance: The malignant cells of patients have mechanisms that may allow them to escape the damaging effects of chemotherapy agents. or become. In each case. In another approach. myeloma and leukemia. This drug. Patients with myeloma have also had remission re-induced by donor lymphocytes. This means that the vaccine induces an immune response against the cancer cells present in the patient. new forms of cancer therapy may be developed. The goal is to extend the duration of remission achieved by remissioninduction therapy of various types. They deliver the toxic substance directly to the cancer cells. gene therapy researchers are trying to modify an oncogene (BCR-ABL) that produces a protein that stimulates malignant cell growth. 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. is approved for older patients with AML who relapse after initial treatment. Many cancer treatment vaccines under development are intended to induce antigen-specific antitumor immune responses. These types of vaccines would be used in patients who have small amounts of residual blood cancer after chemotherapy or stem cell transplantation. Vaccines are in clinical trials for types of acute and chronic leukemia. In patients with CML who have relapsed after stem cell transplantation. the infusion of the original marrow donor’s lymphocytes can re-induce remission. 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. Studies of vaccines used in patients with follicular or indolent lymphoma have demonstrated an immune response. and aptamer treatment.

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. 2007.) • The most common types of leukemia in adults are acute myelogenous leukemia (AML) and chronic lymphocytic leukemia (CLL). Table 3: Source: Cancer Facts & Figures 2007. functional cells to be made. The marrow often no longer produces enough normal platelets.Leukemia Leukemia is a malignant disease (cancer) of the bone marrow and blood.140 6. The lack of normal white cells impairs the body’s ability to fight infections.4 percent of leukemias in children aged 0-19 are CML.570 19. It is characterized by the uncontrolled accumulation of blood cells.790).579 21.800 children. 2007. Statistical Research and Applications Branch.440 Table 2: Sources: SEER (Surveillance.000 2. A shortage of platelets results in bruising and easy bleeding. *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. Estimated 29-Year L-D Prevalence Counts on 1/1/2004 by Duration. 1. Prevalence database: U.960 7.410 4. Only 2.340 13.720 44. In 2007.S. red blood cells and white blood cells. New Cases An estimated 44. more than half of all cases occur after age 67.501 50. aged 0-19.240 new cases of leukemia will be diagnosed in the United States this year.659 people in the United States are living with leukemia.570 3. functionless cells in the marrow and blood. Acute leukemia is a rapidly progressing disease that results in the accumulation of immature.240 Male 3. (About 40. Anemia. DCCPS.380 6. The four major types of leukemia are shown in Table 1. 2004 Type Chronic lymphocytic leukemia Chronic myelogenous leukemia Acute lymphocytic leukemia Acute myelogenous leukemia Prevalence* 95. Chronic leukemias account for 7 percent more of the cases than acute leukemias. • About 33 percent of cancers in children aged 0-14 years are leukemia • Most cases of chronic myelogenous leukemia (CML) occur in adults. each of which can be acute or chronic. Epidemiology.150 24. Leukemia is expected to strike more than 10 times as many adults as children in 2007.440 adults compared with 3. NCI.S. and End Results) Cancer Statistics Review 1975-2004. Prevalence of the Four Major Leukemias as of Jan. Leukemia is divided into four categories: myelogenous or lymphocytic. *Note: Incidence rates are the number of new cases in a given year not counting the preexisting cases. released April 2007. Nearly 54 percent of the new cases of this disease will occur among children in 2007 (about 2. Incidence by Gender Incidence rates* for all types of leukemia are higher among males than among females.200 15. National Cancer Institute. and SEER Program.350 2. • Most cases of leukemia occur in older adults. Chronic leukemia progresses more slowly and allows greater numbers of more mature. Approximate U.800 Female 2. develops in virtually all leukemia patients.570 5. 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. Surveillance Research Program.060 8.189 27. The incidence rates are usually presented as a specific number per 100. The terms myelogenous or lymphocytic denote the cell type involved. • The most common form of leukemia in children is acute lymphocytic leukemia (ALL).060 2. a deficiency of red cells. LEUKEMIA page 6 LYMPHOMA MYELOMA . males are expected to account for 56 percent of the new cases of leukemia. based on the November 2006 SEER data submission.000 population. American Cancer Society.

In 25.799 children under the age of 20 diagnosed with leukemia from 2001-2004. CLL incidence increases dramatically among people who are aged 50 and older. including the examination of the cells in blood or marrow. Figure 3: Source: Cancer Facts & Figures 2007. eighth and ninth decades of life. Incidence by Age-Group Incidence rates by age differ for each of the leukemias. averaging about 189. These signs are not specific to leukemia and may be caused by other disorders. In the 17 SEER regions of the United States. Most children under 15 years of age with ALL are cured. there were 4. ALL incidence was approximately twice that of AML.619 with ALL.922 cases per year. American Cancer Society. Among 15. 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.800 children will be diagnosed with leukemia throughout the United States. Leukemia rates are substantially higher for Hispanic.900 new cases of cancer diagnosed in African-Americans in 2007. 2007. Leukemia is one of the top 15 most frequently occurring cancers in minority groups. LEUKEMIA LYMPHOMA MYELOMA page 7 . The leukemias represented 27 percent of all cancers occurring among children younger than 20 years from 2000-2004. CML incidence also increases dramatically among people who are aged 60 and older.Estimated Proportion of New Cases (%) in 2007 for Each Type of Leukemia Including Adults and Children 3. About 2. From 1975 to 2000. It is estimated that in 2007.to 4-year-old children is more than nine times greater than the rate for young adults ages 20 to 24. The incidence of ALL among 1. The most common form of leukemia among children under 20 years of age is ALL. white and Asian/Pacific islander children than for black children. These cancers are most prevalent in the seventh.to 19-year olds. was 504 per 100. Possible Causes of Leukemia Anyone can get leukemia. AML incidence was approximately 1.to 29-year olds. Leukemia strikes all ages and both sexes.000 population. Some people with chronic leukemia may not have major symptoms and are diagnosed during a medical examination. Adolescents and Young Adults. leukemia rates are higher in Americans of European descent than among those of African descent. Leukemia incidence is highest among whites and lowest among American Indians/Alaskan natives. The cause of leukemia is not known. Hispanic children of all races under the age of 20 have the highest rates of leukemia. The diagnosis of leukemia requires specific blood tests. 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). Although chronic exposure to benzene in the workplace and exposure to extraordinary doses of irradiation can be causes of the disease. The American Cancer Society estimates that there will be approximately 152. Adults. and AML incidence increases dramatically in people who are aged 60 and older. including 3. from 2000-2004. They do warrant medical evaluation. 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. 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.5 times that of ALL. However. Children.790 new cases of childhood ALL are expected to occur in 2007. neither explains most cases.

Thirty-two percent more males than females are living with leukemia. Complete remission means that there is no evidence of the disease and the patient returns to good health with normal blood and marrow cells. The relative survival rates differ by age of the patient at diagnosis.7 percent overall.5 21.1 4. a complete remission (no evidence of disease in the blood or marrow) that lasts five years after treatment often indicates cure.6 2.4 <1 0. race and type of leukemia.4 percent for children under 5 • CLL: 74.2 1. National Cancer Institute.2 10. The five-year relative survival rate has more than tripled in the past 47 years for patients with leukemia.6 10-14 0.8 percent • AML: 20. a patient had a 14 percent chance of living five years. All Types Leukemia. National Cancer Institute.2 15 13 11 9 7.1 for children under 15 • CML: 44. Treatment centers report increasing numbers of patients with leukemia who are in complete remission at least five years after diagnosis of their disease.3 3.9 20-24 0. During 1996-2003. 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. and in 1996-2003. By 1975-1977.000) 17 15.3 percent overall.2 23 21 19 19. when compared to a person without leukemia. the five-year relative survival rate had jumped to 35 percent. 2007. Treatment of Leukemia The aim of treatment is to bring about a complete remission.9 15-19 0.Age-Specific Incidence Rates for Acute Myelogenous Leukemia (All Races). 2007.7 7 5 3 1 0 1. the five-year relative survival rates overall were: • ALL: 65. 2000-2004 25 23.8 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. Epidemiology and End Results) Cancer Statistics Review 1975-2004. Epidemiology and End Results) Cancer Statistics Review 1975-2004.4 5-9 0.4 percent Five-Year Relative Survival Rates for All Ages. 90. gender.8 1-4 0. 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 1. LEUKEMIA page 8 LYMPHOMA MYELOMA .9 25-29 1. the overall relative survival rate was nearly 50 percent. 54. In 1960-1963. Relapse indicates return of the cancer cells and the return of other signs and symptoms of the disease. For acute leukemia.1 Incidence (per 100.

American Cancer Society.940 3.790 Male 820 2.970 250 2. Cancer Statistics Review. 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. Blood. in Children Under 15 Years of Age. about 515 children under the age of 14 are expected to die from leukemia.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. Unclassified forms of leukemia will account for 6.420 deaths from ALL. LEUKEMIA LYMPHOMA MYELOMA page 9 . 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. In 2007. 2007.Five-Year Relative Survival Rates for Acute Lymphocytic Leukemia.990 deaths from AML and 490 deaths from CML.500 deaths from CLL and 1.470 Table 4: Source: Cancer Facts & Figures 2007. 1975-2004. deaths from leukemia are expected to be distributed in the following numbers: In 2007. Implications of long-term survivals in acute stem cell leukemia of childhood treated with composite cyclic therapy. SEER (Surveillance. 2. 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. Despite this decline. Zuelzer WW.320 Female 600 1. 1964:24:477-494. There will be an estimated 8. leukemia will be the fifth most common cause of cancer deaths in men and the sixth most common in women.420 4. Sources: 1. Non-Hispanic whites diagnosed with leukemia over the age of 44 had the highest death rates during this period.470 females.990 490 6.790 deaths in the United States will be attributed to leukemia in 2007: 12.390 additional deaths.500 8.320 males and 9.680 12. Deaths It is anticipated that approximately 21. In 2007. 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. 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.560 5. 2007.390 21. Epidemiology and End Results). There will be an estimated 4.710 9. National Cancer Institute. unclassified forms of leukemia Total Overall 1. leukemia causes more deaths than any other cancer among children and young adults under age 20.

they are 52. including the presence of an abnormal cell called the ReedSternberg cell (a large. These risk factors explain only a small proportion of cases. 2007 Type Hodgkin lymphoma Non-Hodgkin lymphoma Total Male 4.Lymphoma Lymphoma is a general term for a group of cancers that originates in the lymphatic system.9 per 100. Incidence rates for Hodgkin lymphoma tend to be higher among males than among females.S. an average annual percentage increase of 2. Each histologic grouping is diagnosed and treated differently. 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 34.313 people living with Hodgkin lymphoma (active disease or in remission) and 405. Lymphoma results when a lymphocyte (a type of white blood cell) undergoes a malignant change and begins to multiply.670 Female 3. population who are living with lymphoma. The groups are often classified as indolent or aggressive. The reasons for the development of non-Hodgkin lymphoma are not certain. LEUKEMIA page 10 LYMPHOMA MYELOMA . malignant cell found in Hodgkin lymphoma tissues).380 Table 5: Source: Cancer Facts & Figures 2007.190 cases of Hodgkin lymphoma and 63.710 Total 8. Both Hodgkin and non-Hodgkin lymphomas are more common in males than in females. incidence rates for non. eventually crowding out healthy cells and creating tumors that enlarge the lymph nodes or other sites in the body. while 0.7 percent of all cases of non-Hodgkin lymphoma will be diagnosed in children under 15 years of age this year. there are 138.380 Americans will be diagnosed with lymphoma in 2007 (8.266 members of the U. Immune suppression plays a role in some patients. 2007. or low. The Epstein-Barr virus causes Burkitt’s lymphoma in Africa. New Cases of Lymphoma by Gender.190 63.000 at ages 20 to 24 for males and 1.9 per 100. Non-Hodgkin lymphoma is the fifth most common cancer in males and females in the United States.000 for females.200 38. The incidence of Hodgkin lymphoma is consistently lower than that of non-Hodgkin lymphoma. By ages 60 to 64.000 for males and 38.953 people living with nonHodgkin lymphoma for a total of 544. the difference was small. Incidence by Gender Table 5 illustrates the breakdown of incidence of lymphoma by gender.6 per 100. 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. Living with Lymphoma In the United States in 2007. After 50 to 54 years of age.5 percent of all lymphomas diagnosed in 2007. Persons infected with the human immunodeficiency virus (HIV) have a much higher risk of developing lymphoma. rose by 84 percent from 1975 to 2004. In 2004.8 percent.990 32. Age-specific incidence rates of non-Hodgkin lymphoma are 2.3 per 100. Hodgkin lymphoma has characteristics that distinguish it from all other cancers of the lymphatic system. It is the sixth most common cause of cancer deaths in males and in females. in general whites have higher incidence rates than blacks.720 28.190 cases of non-Hodgkin lymphoma). American Cancer Society.Hodgkin lymphoma are higher in Americans of European descent than among those of African descent. Fifty-three percent of the blood cancers diagnosed are lymphomas. More than four percent of all cases of Hodgkin lymphoma diagnosed in 2007 will be in children under 15 years of age. The bacterium Helicobacter pylori is associated with the development of lymphoma in the stomach wall. and each has prognostic factors that categorize it as more or less favorable. Hodgkin Lymphoma Hodgkin lymphoma is a specialized form of lymphoma and will represent about 11. intermediate and high grade.000 for females. New Cases About 71.190 71.

comprising nearly 5 percent of all cancers diagnosed. Adolescents are more commonly diagnosed with Hodgkin lymphoma than young children. Survival for Children Five-year relative survival is 95. lymphomas are most commonly diagnosed in whites (24.Among women.to 24year-old individuals.070 from Hodgkin lymphoma). 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. 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. The rate increases more than 18 times to 45. Non-Hodgkin lymphoma is the ninth most common cause of cancer death in males and the seventh in females in the United States.4 cases per 100. localized non-Hodgkin lymphoma is sometimes treated with radiation. armpit or groin. chemotherapy or both may result in cures for most patients with Hodgkin lymphoma. Early stage. This represents a significant improvement in the rate of recovery. Five-year relative survival is now 95 percent for Hodgkin lymphoma in children aged 0 to 14 years. Hispanics of all races have the second highest incidence rates of non-Hodgkin lymphoma after whites. Lymphomas (Hodgkin lymphoma.400 children under the age of 15 will be diagnosed with cancer in 2007.730 persons will die from lymphoma in the United States in 2007 (18. and more than 46-fold to 112.000 people occur in 20.5 percent. Survival for Adults Hodgkin lymphoma is now considered to be one of the most curable forms of cancer. five-year relative survival for non-Hodgkin lymphoma is now 83. In children under 20 years of age. following leukemia (26.1 cases per 100.8 percent) and neoplasms of the brain and other nervous tissue (17. 1.5/1 million population). excessive tiredness. indigestion and abdominal pain. Deaths An estimated 19.000 by ages 60 to 64. It is rarest among American Indian/ Alaskan native children. In children up to age 14 years. and is the eighth most common cause of cancer death in that group. In the United States. most children with nonHodgkin lymphoma did not live five years after diagnosis. It has remained fairly constant since 1999. Radiation. followed closely by Hispanic children of all races (24.000 persons at ages 80 to 84. night sweats. Death rates have been declining for Hodgkin lymphoma patients since the mid-1970s. sweating at night. depending on the tumor size. From ages 15 to 19.5 percent.9 percent). widespread disease requires chemotherapy or chemotherapy and/or monoclonal antibody therapy with radiation. and non-Hodgkin lymphoma.1 per 100. 3. troublesome itching and weight loss. loss of appetite and bone pain. about 10. The five-year relative survival rate for non-Hodgkin lymphoma patients has risen from 31 percent in whites in 1960-1963 to 63. The most common early sign of other forms of lymphoma is also painless swelling of the lymph nodes – usually in the neck. About 2.000 children in 2004. LEUKEMIA LYMPHOMA MYELOMA page 11 .2 percent for Hodgkin lymphoma in people under 20 years of age.5 percent) are the third most common cancers in children.1 cases per 100. the highest incidence of non-Hodgkin lymphoma is in non-Hispanic whites.0/1 million population). Treatment Hodgkin lymphoma is often treated with radiation and chemotherapy. 4. Incidence in Children The incidence of Hodgkin lymphoma among people under 20 years of age was 1. Treatment for non-Hodgkin lymphoma sometimes includes vaccines and other forms of immunotherapy. In children from 0 to 19 years of age. the highest incidence of non-Hodgkin lymphoma is in Asian/Pacific islanders. Signs and Symptoms Signs and symptoms of Hodgkin lymphoma include painless swelling of lymph nodes in the neck.660 from non-Hodgkin lymphoma. persistent fatigue. Non-Hodgkin lymphoma is the fifth most common cancer in Hispanics. recurrent high fever. The incidence in this group decreased almost steadily and significantly between 1975 and 1999. armpit.8 percent for all races in 1996-2003. cell type and location of the lymphoma. Even in the mid-1970s. groin or in the abdomen. Symptoms also often include fever.

060 9.3 <1* 1-4 5-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85+ Age in Years Figure 7: Sources: SEER (Surveillance.1 102. 2000-2004 6 Incidence (per 100. National Cancer Institute. LEUKEMIA page 12 LYMPHOMA MYELOMA .2 1.8 2.3 4.0 3.8 3.2 4. American Cancer Society.1 0.6 0.1 0.1 4. 2000-2004 110 100 90 80 Incidence (per 100. 2007. Epidemiology and End Results) Cancer Statistics Review 1975-2004.Age-Specific Incidence Rates for Hodgkin Lymphoma. National Cancer Institute. 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 1.4 15. National Cancer Institute.4 2.4 4.000) 70 60 50 40 30 22.6 32.8 112.0 20 10 0 0.9 1.5 10.730 Male 770 9. Epidemiology and End Results) Cancer Statistics Review 1975-2004. Epidemiology and End Results) Cancer Statistics Review 1975-2004. 2007.4 2.660 19. * <16 cases for time interval.0 0. Table 6: Source: SEER (Surveillance.8 4.9 4. 2007.000) 5 4 3 2 1 0 0.0 1.0 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 2007.5 <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.1 63.0 100.370 Female 300 9.4 3.600 10.070 18.4 80. *<16 cases per time interval.0 45.9 3. Age-Specific Incidence Rates for Non-Hodgkin Lymphoma.4 2.1 3.9 7.1 3.4 2.

Recurrent infections may be an early sign of the disease.5/100.3/100.000) of myeloma than those of European descent (5. a B lymphocyte. Total survival for white males. Thalidomide is approved by the FDA for use in treating newly diagnosed myeloma. Figure 9: Source: SEER (Surveillance.4 35.1/100. LEUKEMIA LYMPHOMA MYELOMA page 13 . Treatment Chemotherapy for myeloma has led to sustained remissions in some patients. • The median age at diagnosis for African-Americans is 67. SEER 17 areas (<1. The onset of myeloma interferes with normal production of antibodies and makes myeloma patients susceptible to infections. Approximately 3 percent of all cancer-related deaths among AfricanAmericans in 2000-2004 were from myeloma. 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) is 56 percent higher than for women (4. 5-9. It grows continuously and forms masses of plasma cells. Epidemiology and End Results) Cancer Statistics Review 1975-2004.5 3.1 5.000). 1-4. approximately double. The U.960 men and 8. Bortezomib has been approved for treating myeloma in patients who have had at least two prior therapies. • The median age at diagnosis is 70. Treatment may include intensive chemotherapy followed by stem cell transplantation to restore normal blood cell production.000 to 3. Treatment is aimed at slowing progress of the disease.9 9. 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. tire more easily and feel weak.000). Sixty percent of those were diagnosed with the disease within the past four years. Age-Specific Incidence Rates for Myeloma.3 0. a type of white blood cell found in many tissues of the body.1 Signs and Symptoms Often the first symptom of myeloma is bone pain caused by the effects of myeloma cells in the marrow. Living with Myeloma An estimated 60. but it is the most difficult blood cancer to treat successfully. The highest rates are found in black men 80 to 84 years of age and older (105/100.8 14. From 2000 to 2004. the cell that forms plasma cells. 10-14.1 28.000). 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. two or three drugs are used simultaneously.7 1. Usually. Myeloma was the 10th most common cause of cancer deaths for women in 2000-2004.940 women) new cases of myeloma will be diagnosed in the United States in 2007. Deaths Approximately 10. the patient’s own stem cells are used (autologous stem cell infusion).Myeloma Myeloma is a cancer of the plasma cells. and it rarely occurs in people under age 45. 15-19.790 deaths from myeloma are anticipated this year. Fractures may occur as a result of the weakened bones. In myeloma. but primarily in the bone marrow. destroying normal bone tissue.5/100.0 37. • Americans of African descent have a much higher incidence rate.1 21. (11.2/100. especially.000) for all racial and ethnic groups. Patients may have anemia.900 (10.424 people in the United States are living with myeloma. Malignant plasma cells produce an abnormal protein called monoclonal immunoglobulin. At times.S. *<16 cases for each age interval. 2000-2004 Incidence (per 100. myeloma was the 10th most commonly diagnosed cancer among African-American men and women. • The incidence rate in men (7/100. becomes malignant. 20-24). National Cancer Institute. especially in the marrow. has been increasing.1 0. causing pain and crowding out normal blood cell production. median age at death from multiple myeloma is 74.4 33. 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. The mortality rate from myeloma for people of African descent is more than double the rate for whites (7. New Cases An estimated 19.000) 40 30 20 10 0 0-24 0. It is 71 for African-Americans.

9 17.6 Male 16. All Races.7 24.3 2. Hodgkin and non-Hodgkin lymphoma and myeloma use figures from 2000-2004. for Blacks.3 19.6 2. per 100.3 2. per 100. 2007.000 Population (2000-2004) Type Leukemia Non-Hodgkin lymphoma Hodgkin lymphoma Myeloma Overall 12. Epidemiology and End Results) Cancer Statistics Review 1975-2004.1 Table 10: Source: SEER (Surveillance. the most recent available.4 4.) LEUKEMIA page 14 LYMPHOMA MYELOMA . (Based on SEER 17 areas.5 16. 2007.6 4.2 6. for Whites. per 100.0 Female 8.8 14.000 population and are age-adjusted to the 2000 population. Rates are per 100.Incidence Rates: Leukemia.2 18. National Cancer Institute. National Cancer Institute.0 Female 9.1 11. 2007.5 Incidence Rates by Gender.) Table 9: Source: SEER (Surveillance.000 Population (2000-2004) Type Leukemia Non-Hodgkin lymphoma Hodgkin lymphoma Myeloma Overall 10.2 Male 16.0 7.2 2.) Incidence Rates by Gender. Epidemiology and End Results) Cancer Statistics Review 1975-2004.5 Table 8: Source: SEER (Surveillance. Lymphoma and Myeloma The following tables showing incidence rates for leukemia.2 14.2 3.3 Male 13. National Cancer Institute. (Based on SEER 17 areas. (Based on SEER 17 areas.9 5.0 23. Epidemiology and End Results) Cancer Statistics Review 1975-2004.1 9.1 3.0 2.1 2.4 11.9 2.7 5.6 Female 9.000 Population (2000-2004) Type Leukemia Non-Hodgkin lymphoma Hodgkin lymphoma Myeloma Overall 12.8 20. Incidence Rates by Gender.

Estimated New Cases of Blood Cancers by Site. which is new for 2007. National Center for Health Statistics. total because of rounding and exclusion of estimates that are fewer than 50 cases.010 1. total because of rounding and exclusion of estimates that are fewer than 50 cases.250 1.130 300 80 900 960 300 1. Table 12: Sources: Cancer Facts & Figures 2007. by State.300 110 63.410 130 50 500 490 130 490 * 21.080 1.160 140 50 360 440 170 320 * 18.370 250 280 2. is described by Pickle et al. ***Hodgkin lymphoma estimates are not available for 2007.170 480 1.510 500 60 70 900 380 220 160 280 430 100 370 460 730 310 170 400 70 110 120 80 650 120 1.070 110 1.390 1.540 1. Numbers are rounded to the nearest 10.160 1. **State estimates may not add up to U. American Cancer Society.030 910 620 420 680 680 250 630 1. The method of derivation. model (see below). Note: These estimates are offered as a rough guide and should be interpreted with caution.550 2.180 4. *Estimate is fewer than 50 cases. and additional data supplied by the American Cancer Society.530 1.610 150 2.070 Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Dist.680 920 340 890 170 290 330 190 1. by State.080 600 7. Used with permission.240 170 550 130 800 3. 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. 2007. *Estimate is fewer than 50 cases. American Cancer Society..260 220 400 420 290 2. LEUKEMIA LYMPHOMA MYELOMA page 15 .S.370 100 * 430 380 130 350 * 19. and additional data supplied by the American Cancer Society based on data from the U.240 740 80 1. Centers for Disease Control and Prevention. They cannot be compared with previous years’ estimates to determine cancer incidence trends.S. 2007 State Leukemia Non-Hodgkin Lymphoma Myeloma Hodgkin Lymphoma Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Dist.830 240 230 60 * 1.610 670 610 110 60 3.S.360 960 170 220 2.630 540 80 120 990 510 310 230 320 330 100 390 490 770 400 210 460 80 150 160 100 680 120 1.550 * * * * *20 * * * * 60 * * * 50 * * * * * * * * * * * * * * * * * * 70 * * 50 * * 60 * * * * 80 * * * * * * * 390 Table 11: Sources: Cancer Facts & Figures 2007. Numbers are rounded to the nearest 10.140 380 140 1.790 330 * 320 200 1. January/February 2007.070 80 330 70 480 1.410 560 * 740 230 230 930 70 300 50 350 1.360 610 * 950 290 260 1. Used with permission.150 290 270 70 * 1.310 800 600 900 920 330 1.190 290 * 280 200 1.560 770 890 3. 1969-2004. 2007 State Leukemia Non-Hodgkin Lymphoma Myeloma Hodgkin Lymphoma*** Estimated Deaths from Blood Cancers by Site.710 570 500 2.670 1. CA A Cancer Journal for Clinicians.500 430 1.190 880 870 170 100 4. 2007.880 240 250 50 50 1.520 310 3.660 210 * 190 120 1.200 350 4.030 570 * 610 210 360 1. Mortality Public Use Data Tapes.140 60 260 80 410 1.330 260 780 180 1. Note: These estimates are offered as a rough guide and should be interpreted with caution. numbers are small and NCI and ACS are having difficulty fitting them into the Pickle et al.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 * 10.300 470 90 100 750 430 300 220 290 310 110 320 420 660 350 170 500 80 110 130 90 600 120 1. 2006.040 70 44. 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. **State estimates may not add up to U.

Notes and Definitions Notes The United States does not have a nationwide reporting system or registry for blood cancers.S. 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 relative survival rate is a comparison of survival to a person who is free of the disease. Because of this change in method. This change means that the 2007 incidence estimates are not comparable with previous estimates for determining cancer incidence trends. Thus. mostly upward. survival and mortality have been revised. population. This year. The data can be extrapolated for the entire United States by multiplying by the population ratio. in comparison to the 2002 SEER report. prevalence numbers reported may vary depending upon the method used to determine them. but these figures do not take into account differences in geography. When expressed as a rate. may be incomplete in some cases and the data may reflect adjustments that anticipate changes that will occur once the actual data are received. The data presented in this report are an extrapolation or estimate of the number of cases reported by the 17 Surveillance.. in some cases fewer than 17 SEER regions) and death data from the National Center for Health Statistics. Census. Bureau of the Census’ 2000 population data for that region.S. race or sex. 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. 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. Incidence rates can be calculated based on a number of factors such as age. race and ethnicity in various regions and region-specific health risks. 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. Thus. 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. It considers deaths from all causes. Prevalence may be calculated in a number of different ways. the data presented in the 2007 SEER report placed online on April 15.” We are using the “29-year limited duration” prevalence figures. (Observed survival is the actual percentage of patients still alive at some specified time after diagnosis of cancer. Because of reporting delays from some of the SEER regions. It includes new (incidence) and preexisting cases and is a function of both past incidence and survival. In this report. so the exact number of cases is not known. January/February 2007. The specified date is 1/1/2004 for the prevalence estimates. The SEER (17 region) data cover only about 26 percent of the U. 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. LEUKEMIA page 16 LYMPHOMA MYELOMA . Relative survival rate is an estimate of the percentage of patients who would be expected to survive the effects of the cancer. Definitions Incidence is the number of newly diagnosed cases for a specific cancer or for all cancers combined during a specific time period.S. state-by-state data for incidence of Hodgkin lymphoma are not available because these numbers are so small. if a person is initially diagnosed with melanoma and later develops leukemia. The description of the methods used was published in Pickle et al.S.) Prevalence is the estimated number of people alive on a certain date in a population who previously had a diagnosis of the disease. estimates of cancer incidence. cancer or otherwise. CA A Cancer Journal for Clinicians. only the first diagnosed cancer counts. no matter how long ago that diagnosis was. based on the “first invasive tumor for each cancer site diagnosed during the previous 29 years (1975-2003). In some prevalence statistics. especially in looking at populations in which individuals have had more than one type of cancer. 2007. it is the number of new cases per standard unit of population during the time period. population) that belong to the National Program of Cancer Registries. his or her survival with leukemia may not be counted in leukemia prevalence statistics. Because of changes in the information — such as racial classification — gathered in the 2000 U. Epidemiology and End Results Program (SEER) regions (or. the American Cancer Society changed its method of estimating cancer incidence.

Howlander N. http://seer. Feuer EJ. Epidemiology. MD. “Leukemias. Reichman ME.” Pickle LW. 065767. NIH Pub. In Cancer Epidemiology in Older Adolescents and Young Adults 15 to 29 Years of Age. Horner MJ. Bleyer A. Barr R. 2007.TheOncologist. “Lymphomas and Reticuloendothelial Neoplasms. 2006. and Multiple Primary Cancer Analyses from the Surveillance.” O’Leary M. 065767. No. Including SEER Incidence and Survival: 1975-2000. 39-51.com/cgi/content/full/12/1/20. 25-38. Including SEER Incidence and Survival: 1975-2000. Mariotto A. Reichman M. posted to the SEER Web site 2007. Bleyer A. National Cancer Institute. Barr R. pp. Edwards BK (eds). MD. NIH Pub. Feuer EJ.Citations Source Citations Cancer Facts & Figures 2007. Bleyer A. 174.amcancersoc. Ries LAG (eds). Clegg L. p. January. pp. Bethesda. Melbert D. Bethesda. “Highlights and Challenges. 06-5767. MD. Shu X-O.gov/csr/1975_2004/ LEUKEMIA LYMPHOMA MYELOMA page 17 . Atlanta: American Cancer Society. and End Results (SEER) Program. http://www.” Mattano L Jr. National Cancer Institute. Ward E. Edwards BK. 30-42. Hachey M. Barr R. January/February. No. Nachman J. pp. In Cancer Epidemiology in Older Adolescents and Young Adults 15 to 29 Years of Age. 2006. pp. Tiwari RC. National Cancer Institute. O’Leary M.org/cgi/content/full/57/1/30. 2006. O’Leary M. 57. MD.” Hayat MJ. Atlanta: American Cancer Society. Cheson B. “A New Method of Estimating United States and State-Level Cancer Incidence Counts for the Current Calendar Year. NIH Pub. based on November 2006 SEER data submission. 12. Barr R. Including SEER Incidence and Survival: 1975-2000. 2007. “Cancer Statistics. Keller F. Stock W. The Oncologist Vol. CA A Cancer Journal for Clinicians Vol. Miller BA. 2007. Ries LAG (eds). 1975-2004. Cancer Facts & Figures for African Americans 2007-2008. Ries LAG. Eisner MP. Trends. Sheaffer J. National Cancer Institute. http://caonline. Hao Y. Bethesda. 20-37. Howe HL. Bethesda. Jemal A. Zou Z. Ross J.” Bleyer A. No. Epidemiology. Krapcho M. Howlader N. SEER (Surveillance. Ries LAG (eds). and End Results) Cancer Statistics Review. 2007. O’Leary M. In Cancer Epidemiology in Older Adolescents and Young Adults 15 to 29 Years of Age.cancer.

The participating scientists may be at different institutions or from any country. each focused on the discovery of new approaches to benefit patients or those at risk for developing leukemia. Thus. lymphoma.000 over three years.About the Society The Leukemia & Lymphoma Society is the world’s largest voluntary health organization dedicated to funding blood cancer research and providing education and patient services. the Society has awarded more than $550 million in research grants. lymphoma and myeloma that is intended to advance treatment.000 a year for a total of $550. They are: 1) Career Development Program (CDP)-basic research. research reaching a clinical trial can receive $1 million over five years to facilitate new drug discovery or advances in diagnosis or prevention.000 over three years. to a total cost of $6.000 over three years. Hodgkin’s disease and myeloma. lymphoma or myeloma. Research grants are awarded in three program areas: Career Development. are granted each year.000 over five years. The Grant Review Process Scientists and physician-scientists who are experts in the field of leukemia. lymphoma and myeloma should be encouraged worldwide. or control of. 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. Career Development Program The Career Development Program supports promising young scientists (Scholars.25 million per year over a five-year period. treatment or prevention of leukemia. The program is expected to generate new knowledge and breakthrough discoveries. diagnosis or prevention in the near term.000 over five years.000 a year for a total of $150. Translational Research and the Specialized Center of Research (SCOR). • Fellows are awarded $50. and improve the quality of life of patients and their families. Translational Research • Scholars in Clinical Research are awarded $110. The SCOR program brings together research teams working in complementary areas. Research Research Grant Programs The Society’s research programs are based on the belief that all scientifically sound approaches toward a cure for.000. Funding for two additional years may be provided for highly promising projects that are entering phase I clinical trial. Translational Research Awards are made for an initial three-year period. • Special Fellows in Clinical Research are awarded $60. 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 . Now supporting $61. The Society is a nonprofit organization that relies on the generosity of individual and corporate contributions to advance its mission.000 a year for a total of $180. The SCOR grants also support scientific core laboratories to provide access to innovative technology if required by the participating research programs.000 a year for a total of $550. leukemia. lymphoma and myeloma. Translational Research Program The Translational Research Program provides early-stage support for research on leukemia. leading to better survival rates and prevention measures for patients.6 million annually on research. Awards go to those groups that best demonstrate the synergy that will occur from their close interaction.25 million. 3) Translational Research Program. Each SCOR is funded up to $1. Since the first funding in 1954. 2) CDP-clinical research. for a total of $600. • Special Fellows are awarded $60. the Society’s grant programs are among the most prestigious in the fields of blood cancers. We offer a wide variety of programs and services in support of our mission: Cure leukemia.000 a year for a total of $180. The Specialized Center of Research (SCOR) in Leukemia. Awards up to $200. lymphoma and myeloma research comprise four review subcomittees. 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.000 per year for three years.

including support groups. families. treatments. First Connection: This program links newly diagnosed patients to a peer volunteer who has experienced a similar diagnosis. Educational Materials An extensive collection of free educational materials are offered to patients and health professionals. As of June 30. 9 a. Professional Education The Society serves the continuing educational needs of the medical and research community through professional symposia offered throughout the year.LLS. myeloma. Guidelines. the Society distributes more than 1 million booklets. to 6 p. where medical professionals share the latest research findings.org. 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.LLS. and click “Live Help. Patients.LLS. LEUKEMIA LYMPHOMA MYELOMA page 19 . podcasts and Webcast archives of these programs are available at www. The Society also hosts numerous teleconferences and Webcasts. The Society funds several Focused Workshops each year on important topics relevant to hematological malignancies. brochures and videos through the IRC and local Society chapters. lymphoma. to 5:00 p. These offices conduct lifeenhancing patient services. Each year. lymphoma and myeloma. each group provides information and support. and encourages greater communication among patients. Guided by two volunteer oncology health professionals. friends and healthcare professionals.m. the Translational Research Grant Progress Review Meeting and the SCOR Progress Review Meeting. They are available to talk one-onone. their families and healthcare professionals.org/copay.org. lymphoma. information about our peer-to-peer program First Connection and other programs. ET. serves a wide variety of education and information needs.important projects to advance the Society’s mission. Teleconferences and Webcasts The Society sponsors more than 25 educational teleconferences and Webcasts each year on topics of interest to patients and caregivers. families and professionals may call the IRC toll free at (800) 955-4572 in addition to corresponding by email at infocenter@LLS. www.org. Monday through Friday. instructions.m. The Society’s Web Site The Society’s Web site. These include the Stohlman Scholar Symposium.org. Information specialists are oncology social workers and health educators who provide callers with current information on blood cancers.org.org or by or emailing researchprograms@LLS. is held each December on the Friday immediately before the American Society of Hematology meeting. A trained patient volunteer currently in remission phones the new patient to share information and support. peer counseling and patient financial aid. This support should advance the understanding.org. The educational program offers varying formats to facilitate the exchange of information and ideas on the newest developments in cancer research and treatment. Patient Services The Society has a network of 68 chapters throughout the United States and Canada. The IRC is a worldwide link to information and resources useful to patients. 2007 the Society will have 379 active grantees at 116 institutions in the United States and abroad.LLS. www. Much of the content of these materials is available to view and download at www. Co-Pay Assistance Program Patients with AML. sponsored by the Society. Information Resource Center (IRC) The Society strives to be the world’s foremost source of information on leukemia. on the Society’s Web site.org or faxing to (914) 949-6691 or contacting the Research Department at (914) 949-5213. The user has the opportunity to create personalized pages with identified interests.” Chapter Programs: Family Support Groups: The Society has developed more than 360 Family Support Groups at 68 chapters. Patients needing assistance may apply on the Society’s Web site. myelodysplastic syndromes (MDS) and other blood cancers.LLS.org. Other meetings are held for the Society’s grantees. The site features a comprehensive overview of blood cancers. Information on registration for these free events can be accessed at www. treatment and prevention of leukemia. audio. from 10:00 a. the Society’s programs and services. You may also chat online with an information specialist.m.LLS. ET. www. It is continually being updated and expanded to support and promote the Society’s mission. Family Support Group locations.m. and applications for the Society’s three research programs may be obtained by visiting www.LLS. clinical trials and offer guidance on coping. call (877) LLS-COPAY ([877] 557-2672) or email copay@LLS. The Annual Research Symposium.

LLS. staging and classification of nonHodgkin lymphoma (NHL). New insights. how cancer drugs are developed and what the emerging treatment options are for leukemia. unrestricted educational grant from Genentech BioOncology and Biogen Idec Inc. Patient financial aid funds are subject to availability.org and is being sponsored by a generous. treatments and future directions for NHL are also discussed. the Society has helped patients demonstrating a need for financial assistance cover a portion of their treatment costs. 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. families and healthcare professionals with a clear description of what clinical trials are. This program is also accessible as a Webcast at www. The patient education program was funded at $18 million through 2007. lymphoma and myeloma. This program is made possible by the Lance Armstrong Foundation.Patient Financial Aid Program: For more than 31 years. Through the Patient Financial Aid Program. treatments. emerging therapies and managing side effects and how to find emotional support when living with the illness. the Society’s advocacy program has been a strong voice in Washington. The Society has identified key issues that currently shape its advocacy agenda. and offers numerous resources that can assist childhood cancer survivors to flourish in the school environment posttreatment. In 2002. It is supported by Amgen Oncology. CML Issues and Insights: A Nursing Education Program on Chronic Myelogenous Leukemia. New Directions in Myeloma Therapy: This program presents an overview of myeloma. that program has funded some $30 million in additional blood cancer research. Society volunteers and staff visit Capitol Hill regularly to lobby Congress in support of issues that impact research and patient care. parents. This program is being sponsored by an unrestricted education grant from Novartis Oncology. providing additional support for blood cancer patients and their families nationwide. The Path to Progress: Clinical Trials in Blood Cancers: This program provides patients. the Society successfully lobbied Congress for legislation that authorizes a new blood cancer research effort at the NCI and creates a new blood cancer education program for patients and the public under the Centers for Disease Control and Prevention. the Society has successfully ensured coverage of routine care in cancer clinical trials in three states and secured additional funding for patient support programs in four others. Meet the Expert on Non-Hodgkin Lymphoma: This program presents basic information on terminology. This Society program is being supported by Celgene Corporation and Millennium Pharmaceuticals. Working through chapters across the country. 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. reimbursement of up to $500 per year helps cover the costs of transportation. Welcome Back: Facilitating the Return to School for Children with Cancer: A new addition to The Trish Greene Back to School Program. local volunteers and staff are building a grassroots advocates’ network to rally patients and their families to promote common goals related to cancer research and treatment. Printed literature. This nursing education program provides an overview of CML. On the state level. This program is provided through an unrestricted educational grant from Millennium Pharmaceuticals. drugs and various treatments not covered by insurance. To date. 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. diagnosis. Department of Defense’s medical research program. treatments.S. LEUKEMIA page 20 LYMPHOMA MYELOMA . representing to policy makers at all levels of government the healthcare quality concerns and medical research interests of patients and their families. In 2001. DC. this education program discusses possible emotional and cognitive short.and long-term effects that children may experience after treatment. emerging therapies and side effects and addresses the unique challenges of nursing management of these patients. Advocacy Since 1994. videos and other materials to aid the process are available through all local chapters. risk factors. patients and school personnel to assure youngsters a smooth transition from active treatment back to school.000 and has become a potent voice in public policy deliberations. the Society successfully lobbied Congress to institute a blood cancer research initiative as part of the U.

. The Leukemia & Lymphoma Society extends special thanks to Myrna Watanabe..Acknowledgements Additional data from SEER*Stat Databases at http://www. It is distributed as a public service by The Leukemia & Lymphoma Society Inc. with the understanding that the Society is not engaged in rendering medical or other professional services. Milton Eisner of SEER. This publication is designed to provide information in regard to the subject matter covered. provided ACS’s state-by-state statistics on myeloma and Hodgkin lymphoma. of the American Cancer Society (ACS).cancer.gov.seer. NCI. Ph. for compilation of data for this publication.D. and Rebecca Siegel. provided statistical assistance.

org Our mission: Cure leukemia. The Society is a nonprofit organization that relies on the generosity of individual. PS80 35M 6/07 . Hodgkin’s disease and myeloma.Home Office 1311 Mamaroneck Avenue. Suite 310 White Plains.HELP.LLS. New York 10605 Tel: 888.LLS Information Resource Center (IRC): 800.4572 www.955. and improve the quality of life of patients and their families. corporate and foundation contributions to advance its mission. lymphoma.

Sign up to vote on this title
UsefulNot useful