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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.
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. 71. This statistic represents 143 people each day. 1996. Deaths • Leukemia. 1975-2004.790 people will die from myeloma.310 people in the United States this year. National Cancer Institute. • Every five minutes. someone dies from a blood cancer. 44. in April 2007.424 people living today with myeloma. www.070 from Hodgkin. the incidence of myeloma increased 8 percent. • In general. 19. an annual publication.1975-1977 vs. • Every 10 minutes. lymphoma and myeloma in 2007. • These blood cancers will account for 9.380 new cases of lymphoma will be diagnosed in the United States (8. 1996-2003 100% 90% 80% 70% Survival Rates 60% 50% 40% 30% 20% 10% 0% Myeloma Hodgkin Lymphoma Non-Hodgkin Lymphoma Leukemia 34% 26% 12%* 14% 48% 40% 31% 74% 64% 50% 35% 86% Leukemia: • There are 218.920 new cancer cases diagnosed in the United States this year. • Thirty-two percent more males are living with leukemia than females.790 people will die of leukemia. lymphoma and myeloma will cause the deaths of an estimated 52. *except acute myelogenous leukemia (AML) and other.953 either have or are in remission from non-Hodgkin lymphoma (NHL). 2nd Edition.266 people living today with lymphoma. • Leukemia causes more deaths than any other cancer among children and young adults under the age of 20.Executive Summary Facts 2007-2008.seer. • Eighty-six percent of myeloma cases occur in people aged 55 and over. Myeloma: • • • • There are 60. Epidemiology and End Results) Cancer Statistics Review. • In 2007. page 16).3 percent of the deaths from cancer in 2007 based on the 559. LEUKEMIA LYMPHOMA MYELOMA page 1 . Oxford University Press.349 Americans are living with leukemia. nonacute myelogenous and monocytic leukemias Lymphoma: • There are 544. the National Cancer Institute’s Surveillance. Five-Year Relative Survival Rates 1960-1963 vs. lymphoma and myeloma. 1960-1963 1975-1977 1996-2003 Figure 1: Sources: SEER (Surveillance. someone is diagnosed with a blood cancer.313 either have or are in remission from Hodgkin lymphoma. which becomes malignant and multiplies continuously. 138.659 people in the United States who are either living with or are in remission from leukemia. or nearly six people every hour. Survival • An estimated 823.240 people will be diagnosed with leukemia. • Non-Hodgkin lymphoma is the fifth most common cancer in the United States. 21. 10. From 1975 to 2004. • In 2007. lymphoma and myeloma decreased from 1995 to 2004 (the last year data were available).gov.4 percent of the 1.cancer. More males are diagnosed with leukemia and more males die of it than females. 63. Highlights from the Report Include: New Cases • An estimated 135. • This year. and myeloma.520 people in the United States will be diagnosed with leukemia. • New cases of leukemia.190 cases of non-Hodgkin). These data were published online by SEER. Hodgkin and non-Hodgkin lymphoma and myeloma will account for nearly 9.900 people will be diagnosed with myeloma. This year. National Cancer Institute. Leukemia.730 people will die from lymphoma (1. the likelihood of dying from most leukemias*. • This year. 2007 and SEER 19731993. The data within Facts 2007-2008 reflect the most recent statistics available from SEER. 1998.660 from non-Hodgkin). *Myeloma Biology and Management. This year.190 cases of Hodgkin. 405. and its age-adjusted incidence rose by nearly 84 percent from 1975 to 2004. is a compilation of the most recent data on leukemia. Epidemiology and End Results Program. 19. The next SEER Cancer Statistics Review is expected to be published online in April 2008. Cancer Statistics Review 1975-2004 (see Notes. This abnormal accumulation interferes with the production of healthy blood cells. Hodgkin and non-Hodgkin lymphoma.650 total cancer-related deaths.444. Mortality from the disease increased 24 percent. 18.
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. If a sibling is not available. The blood or marrow stem cells are collected while the patient is in remission. (Numbers do not add up to 100% because of rounding. Patients with acute lymphocytic leukemia (ALL). 2007. especially for children. The accumulation of malignant cells interferes with the body’s production of normal blood or immune cells and can result in severe anemia. These diseases usually result from an acquired genetic injury to the DNA of a single cell. They are considered to be related cancers because they arise from cells with a common origin (the lymphohematopoietic stem cells) and with related functions. Autologous transplantation uses the patient’s own marrow stem cells and is technically not transplantation since another person is not the donor. An allogeneic transplant uses blood or marrow stem cells from a normal donor. 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. which becomes abnormal (malignant) and multiplies continuously. Approximately 50 different drugs are now being used in the treatment of these diseases. is largely responsible for the dramatic improvement in managing leukemia and lymphoma. Patients with leukemia. some types of Hodgkin lymphoma.About the Diseases Leukemia. large localized areas of nonHodgkin lymphoma or with special complications that are amenable to radiation therapy may receive both primary chemotherapy and ancillary radiation therapy. The technique is important. studies suggest that two matched cord donors may result in a higher success rate in larger adults. 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. 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. for which a parent rather than a sibling could be the 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. The technique of harvesting stem cells from blood and cord blood has made transplantation available for more LEUKEMIA page 2 LYMPHOMA MYELOMA . usually a brother or sister with the same tissue type. lymphoma and myeloma. Syngeneic transplant describes the use of an identical twin as donor. a search of the National Marrow Donor Program registry of tissue-typed volunteers could be made for a matched unrelated donor. Hodgkin and non-Hodgkin lymphoma and myeloma are cancers that originate in a cell in the bone marrow or lymphatic tissues. usually in combinations of two or more drugs. The harvesting. American Cancer Society. freezing and storing of cord blood have provided another source of stem cells for transplantation. The numbers of stem cells in cord blood are often insufficient for the needs Figure 2: Source: Cancer Facts & Figures. In special instances. Stem cells also circulate in large numbers in fetal blood and can be recovered from umbilical cord and placental blood after childbirth. decreased ability to fight infections and a predisposition to bleeding. However. myeloma and lymphoma are usually treated with chemotherapy. slightly mismatched cord stem cell donors may be used quite successfully. Research is being conducted to improve socalled “haploidentical” transplant. especially in young children. Such an approach would greatly lessen the proportion of children without a donor. 2007. There are two major types of stem cell transplants: syngeneic and allogeneic.
Some treatment centers have follow-up clinics that provide a comprehensive. Follow-Up Care Regular medical follow-up enables doctors to assess the full effect of therapy. multi-disciplinary approach to monitoring and supporting cancer survivors. but some follow adult cancer survivors. ablation of the recipient’s blood-cell forming and immune cells was the price that had to be paid to eradicate the leukemia. the donor’s cells take hold and the patient’s leukemia. Blood and cord blood transplants differ from marrow transplants principally in the source of the cells collected for transplant. Regular examinations may include screening for cancer recurrence or the development of secondary cancer or other late effects of treatment. Cancers (http://www. Coordination between specialists and primary care physicians is essential to provide the best care possible. This still experimental approach greatly lessens the early toxicity of transplantation and has extended the age at which recipients with leukemia. Development of New Drugs: In the past decade. lymphoma or myeloma is attacked and suppressed by donor lymphocytes that form from the donor stem cells. “Ablation” referred to wipingout the recipient’s cancer. lymphoma or myeloma and permit the donor’s cells to be accepted by the temporarily immunodeficient recipient. Stem cells not only reside in the marrow but also circulate in the blood. The protein is an enzyme in the family of tyrosine kinases. New Approaches to Treatment Several areas of research have resulted in new approaches to the treatment of leukemia. Cancer survivors should have physical examinations yearly or more often. lymphoma and myeloma. 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.patients. 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. as well as marrow. In nonablative transplantation. Over time. identify recurrence of the disease and detect long-term or late effects. two second-generation agents. frozen and stored and later transplanted in the patient. 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. In standard stem cell transplantation.childrensoncologygroup. lymphoma or myeloma can have an allogeneic transplant. the recipient’s blood cell and immune system are preserved. these cells can be harvested from the blood of a donor. To ensure there will be enough blood stem cells for successful transplantation. 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. “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. or genetic factors that can increase susceptibility to certain effects. This “graft versus leukemia or lymphoma effect” can suppress (cure) the malignancy and is a prolonged (indefinite) form of immunotherapy. as needed. few severe adverse effects on normal tissues and a very high response rate. 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. Although a minority of patients have developed resistance to the drug. thereby allowing doctors to plan treatment accordingly. marrow and immune system. Because blood.org/). Adolescent. and Young Adult LEUKEMIA LYMPHOMA MYELOMA page 3 . donors of blood stem cells require special treatment to mobilize sufficient stem cells from marrow into their blood before cells are harvested. Identifying these biomarkers will allow researchers to develop tests that can predict what effects an individual is at risk of developing. several important new drugs and new uses for existing drugs have greatly improved cure rates or remission duration for some patients with leukemia. Cancer survivors should see their primary care physicians for general health examinations and an oncologist for follow-up care related to cancer. making the procedure more tolerable. Imatinib mesylate (Gleevec®) is now the drug of choice in newly diagnosed patients with chronic myelogenous leukemia (CML). is a source of stem cells for transplantation. decreased side effects. Most follow-up clinics specialize in pediatric cancer survivors. Follow-Up Guidelines: The Children’s Oncology Group has established Long-Term Follow-Up Guidelines for Survivors of Childhood. Biomarkers could be high levels of certain substances in the body such as antibodies or hormones.
a less common type of chronic lymphocytic leukemia (CLL).S. 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). Cladribine induces long-term remissions in nearly 90 percent of patients treated at diagnosis for one week. Pentostatin is another effective drug that can be used in patients with hairy cell leukemia who do not respond to cladribine. doxorubicin (Adriamycin®). a thalidomide derivative. 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. and Decitabine (Dacogen®).dasatinib (Sprycel®)(approved by the U. LEUKEMIA page 4 LYMPHOMA MYELOMA . and enhances the specificity of treatment to minimize toxic effects on normal tissues. thus rituximab is an anti-CD20 antibody. has improved dramatically with the introduction of cladribine. Rituximab is an antibody directed at the target CD20 antigen on B-cell lymphoma cells. is being used to treat relapsed or refractory acute lymphocytic leukemia (ALL) in children who have received at least two prior therapies. Some patients with moderately severe. reducing the need for transfusions in some patients. immune cell administration and vaccine development. it has now become an important fifth drug in the R-CHOP–rituximab. It is especially active against the lymphocytes in CLL. approved by the FDA for all types of MDS. Early studies indicate the combination of arsenic trioxide and all-trans retinoic acid may be a further advance in the initiation of therapy. Other therapies in clinical research to treat MDS include arsenic trixoxide. Velcade is approved by the FDA for treating people with myeloma who have had at least one prior therapy. farnesyl transferase inhibitors and reduced-intensity stem cell transplantation. 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. In May 2006. Azacitidine (Vidaza®). in combination with dexamethasone. symptomatic anemia have improvement in hemoglobin levels with this agent. the most prevalent lymphoma subtype. principally. Gleevec is not only a very important new agent in the treatment of CML. cyclophosphamide. Rituximab has become an important agent to treat CD20-positive lymphocytic malignancies. Indeed. Lenalidomide (Revlimid®). Clofarabine (Clolar®). 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. Food and Drug Administration [FDA] in 2006) and nilotinib (in clinical trials). suppresses the progression of leukemia. Arsenic trioxide also adds to the drugs available to treat this subtype of acute leukemia. The treatment of hairy cell leukemia. but it can also induce remissions in some cases of acute leukemia. however. Monoclonal antibodies have added to the arsenal of agents that are used for the treatment of patients with lymphoma and leukemia. 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. In patients with anemia. was approved by the FDA for newly diagnosed myeloma. such as follicular lymphoma. are entering clinical use and can overcome this resistance in some cases. This drug is also being tested in clinical trials to treat adult acute leukemia and MDS. lymphoma or myeloma. PDGFR or KIT oncoproteins). vincristine (Oncovin®) and prednisone–therapy for diffuse large B-cell lymphoma. Alemtuzumab (Campath®) is a monoclonal antibody directed against the antigen CD52 found on T and B lymphocytes. chronic eosinophilic leukemia (formerly hypereosinophilic syndrome). perhaps 20 percent of cases also derive benefit. Revlimid is approved by the FDA in combination with dexamethasone for the treatment of myeloma patients who have received at least one prior therapy. Patients with more severe forms of MDS are very unlikely to respond to the agent. 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®). Three types of immunotherapy are being explored: antibody treatment. but without this specific chromosome 5 abnormality. approved by the FDA in 2005. Monoclonal Antibody Therapy: Monoclonal antibodies are laboratory-produced proteins that can be infused into an appropriate patient. thalidomide (Thalomid®). although initially used in indolent lymphomas. kill unhealthy bone marrow cells and may help the bone marrow function more normally in MDS patients. Cell surface antigens have been given a cluster designation (CD) followed by a number.
These cells are. Many cancer treatment vaccines under development are intended to induce antigen-specific antitumor immune responses. In studies of CML. 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. gene therapy researchers are trying to modify an oncogene (BCR-ABL) that produces a protein that stimulates malignant cell growth. some vaccines are made from leukemic cells treated in test tubes to convert them to potent antigen-presenting cells. These types of vaccines would be used in patients who have small amounts of residual blood cancer after chemotherapy or stem cell transplantation. This type of treatment is being studied intensively to learn more about the basis for this immune cell effect and to expand it for use in other situations. Reversal of Multidrug Resistance: The malignant cells of patients have mechanisms that may allow them to escape the damaging effects of chemotherapy agents. If the gene in the former case is an oncogene or the protein in the latter case is an oncoprotein. less responsive to therapy. is approved for older patients with AML who relapse after initial treatment. or become. 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. the patient’s immune cells would be treated in the laboratory to train them to attack the residual leukemia. In some approaches. The goal is to extend the duration of remission achieved by remissioninduction therapy of various types. In another approach. In patients with CML who have relapsed after stem cell transplantation. gemtuzumab (Mylotarg®). myeloma and leukemia. They deliver the toxic substance directly to the cancer cells. LEUKEMIA LYMPHOMA MYELOMA page 5 . An alternative strategy called molecular targeted drug development targets the oncoprotein. lymphoma and myeloma. Monoclonal antibodies can also be linked to a radioactive isotope to target and kill specific cancer cells. new forms of cancer therapy may be developed. Vaccines are in clinical trials for types of acute and chronic leukemia. b) a modality that uses molecules of RNA to silence complementary (DNA) genes. Vaccines: Experimental treatment vaccines are now being studied to treat certain types of lymphoma. the infusion of the original marrow donor’s lymphocytes can re-induce remission. This means that the vaccine induces an immune response against the cancer cells present in the patient. the basis for the vaccine is to make the cancer cells susceptible to immune attack by heightening the recognition of markers on the cancer cells. In one approach. a technique that prepares small molecules in the laboratory that have the ability to inactivate proteins that cause disease. 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. These drugs have been approved to treat relapsed B-cell non-Hodgkin lymphoma. cells are isolated in the laboratory and start making antibodies after insertion of the cancer antigen. Two new and potentially important approaches include a) the application of RNA interference. and aptamer treatment. Approaches to reversing multidrug resistance are under study.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. These agents are currently being tested in patients with AML and myeloma in the hope that they may decrease drug resistance and increase the rate of a prolonged response to therapy. In each case. 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. The goal of several new agents being studied is to decrease resistance to an important chemotherapy drug used in leukemia. lymphoma or myeloma cells. DNA vaccines that contain the DNA that encodes the specific antigen are being tested. drugs are designed to interfere with the oncoprotein and prevent its effect on the cell. This drug. Patients with myeloma have also had remission re-induced by donor lymphocytes. Examples of this treatment are the drugs ibritumomab (Zevalin®) and tositumomab and iodine I131 tositumomab (Bexxar®). Paradoxically. These are called conjugated monoclonal antibodies. Studies of vaccines used in patients with follicular or indolent lymphoma have demonstrated an immune response.
240 new cases of leukemia will be diagnosed in the United States this year.000 2.440 Table 2: Sources: SEER (Surveillance.790). Chronic leukemias account for 7 percent more of the cases than acute leukemias.501 50. • The most common form of leukemia in children is acute lymphocytic leukemia (ALL). aged 0-19. • Most cases of leukemia occur in older adults. and SEER Program. The incidence rates are usually presented as a specific number per 100.S. Leukemia is divided into four categories: myelogenous or lymphocytic. The terms myelogenous or lymphocytic denote the cell type involved.240 Male 3. Acute leukemia is a rapidly progressing disease that results in the accumulation of immature.) • The most common types of leukemia in adults are acute myelogenous leukemia (AML) and chronic lymphocytic leukemia (CLL).189 27.4 percent of leukemias in children aged 0-19 are CML. Prevalence database: U. Surveillance Research Program. *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. a deficiency of red cells. New Cases An estimated 44.440 adults compared with 3. 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. red blood cells and white blood cells. NCI. The marrow often no longer produces enough normal platelets. released April 2007. functional cells to be made. Incidence by Gender Incidence rates* for all types of leukemia are higher among males than among females. based on the November 2006 SEER data submission. Statistical Research and Applications Branch. DCCPS.720 44. The lack of normal white cells impairs the body’s ability to fight infections.000 population. 2007. American Cancer Society. In 2007. Anemia.Leukemia Leukemia is a malignant disease (cancer) of the bone marrow and blood. Nearly 54 percent of the new cases of this disease will occur among children in 2007 (about 2. (About 40. and End Results) Cancer Statistics Review 1975-2004.380 6.060 2. Table 3: Source: Cancer Facts & Figures 2007. Epidemiology. Leukemia is expected to strike more than 10 times as many adults as children in 2007. *Note: Incidence rates are the number of new cases in a given year not counting the preexisting cases.570 19.150 24.060 8. Chronic leukemia progresses more slowly and allows greater numbers of more mature. 1. Approximate U.200 15. 2007.570 5. more than half of all cases occur after age 67. Prevalence of the Four Major Leukemias as of Jan. Estimated 29-Year L-D Prevalence Counts on 1/1/2004 by Duration. 2004 Type Chronic lymphocytic leukemia Chronic myelogenous leukemia Acute lymphocytic leukemia Acute myelogenous leukemia Prevalence* 95. The four major types of leukemia are shown in Table 1.570 3.659 people in the United States are living with leukemia.350 2.800 children.S. each of which can be acute or chronic.410 4. males are expected to account for 56 percent of the new cases of leukemia.340 13.140 6. • About 33 percent of cancers in children aged 0-14 years are leukemia • Most cases of chronic myelogenous leukemia (CML) occur in adults.579 21. National Cancer Institute. A shortage of platelets results in bruising and easy bleeding. develops in virtually all leukemia patients. It is characterized by the uncontrolled accumulation of blood cells. LEUKEMIA page 6 LYMPHOMA MYELOMA .800 Female 2. Only 2.960 7.289 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. functionless cells in the marrow and blood.
American Indian/Alaskan natives. 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). averaging about 189. Possible Causes of Leukemia Anyone can get leukemia. The most common form of leukemia among children under 20 years of age is ALL. eighth and ninth decades of life. including 3. In 25.to 4-year-old children is more than nine times greater than the rate for young adults ages 20 to 24.5 times that of ALL. the incidence of AML slowly rose while that of ALL steadily decreased in the period from late adolescence to older adulthood. It is estimated that in 2007. The diagnosis of leukemia requires specific blood tests.799 children under the age of 20 diagnosed with leukemia from 2001-2004. About 2. Children. there were 4.900 new cases of cancer diagnosed in African-Americans in 2007. Adolescents and Young Adults. Leukemia is one of the top 15 most frequently occurring cancers in minority groups.800 children will be diagnosed with leukemia throughout the United States. These cancers are most prevalent in the seventh. Among 15. Hispanic children of all races under the age of 20 have the highest rates of leukemia. leukemia rates are higher in Americans of European descent than among those of African descent. was 504 per 100.to 19-year olds. LEUKEMIA LYMPHOMA MYELOMA page 7 .922 cases per year. including the examination of the cells in blood or marrow. The incidence of ALL among 1. The American Cancer Society estimates that there will be approximately 152. and AML incidence increases dramatically in people who are aged 60 and older.000 population. From 1975 to 2000. 2007. from 2000-2004.619 with ALL. 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.Estimated Proportion of New Cases (%) in 2007 for Each Type of Leukemia Including Adults and Children 3. The leukemias represented 27 percent of all cancers occurring among children younger than 20 years from 2000-2004. In the 17 SEER regions of the United States. AML incidence was approximately 1. They do warrant medical evaluation. 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. Adults.to 29-year olds. Leukemia incidence is highest among whites and lowest among American Indians/Alaskan natives. CML incidence also increases dramatically among people who are aged 60 and older. Leukemia rates are substantially higher for Hispanic. neither explains most cases. However.790 new cases of childhood ALL are expected to occur in 2007. ALL incidence was approximately twice that of AML. The cause of leukemia is not known. Figure 3: Source: Cancer Facts & Figures 2007. Some people with chronic leukemia may not have major symptoms and are diagnosed during a medical examination. These signs are not specific to leukemia and may be caused by other disorders. Incidence by Age-Group Incidence rates by age differ for each of the leukemias. Leukemia strikes all ages and both sexes. Although chronic exposure to benzene in the workplace and exposure to extraordinary doses of irradiation can be causes of the disease. The incidence rate for all cancers among AfricanAmericans in the Seer (17 region). white and Asian/Pacific islander children than for black children. Most children under 15 years of age with ALL are cured. CLL incidence increases dramatically among people who are aged 50 and older. American Cancer Society.
Complete remission means that there is no evidence of the disease and the patient returns to good health with normal blood and marrow cells.4 <1 0. 54.2 23 21 19 19. 2000-2004 25 23. 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 overall relative survival rate was nearly 50 percent. Epidemiology and End Results) Cancer Statistics Review 1975-2004.9 25-29 1.7 7 5 3 1 0 1. a patient had a 14 percent chance of living five years.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. During 1996-2003.2 15 13 11 9 7. 2007. The five-year relative survival rate has more than tripled in the past 47 years for patients with leukemia.8 1-4 0. and in 1996-2003. In 1960-1963. when compared to a person without leukemia.1 Incidence (per 100.5 21. The relative survival rates differ by age of the patient at diagnosis. National Cancer Institute.4 percent Five-Year Relative Survival Rates for All Ages.2 1.Age-Specific Incidence Rates for Acute Myelogenous Leukemia (All Races). By 1975-1977. the five-year relative survival rates overall were: • ALL: 65.7 percent overall.3 percent overall.1 4.000) 17 15. All Types Leukemia.8 percent • AML: 20. the five-year relative survival rate had jumped to 35 percent. 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.6 10-14 0.2 10.1 for children under 15 • CML: 44. Epidemiology and End Results) Cancer Statistics Review 1975-2004.9 15-19 0. a complete remission (no evidence of disease in the blood or marrow) that lasts five years after treatment often indicates cure.6 2. Treatment centers report increasing numbers of patients with leukemia who are in complete remission at least five years after diagnosis of their disease. Thirty-two percent more males than females are living with leukemia. 2007.3 3. LEUKEMIA page 8 LYMPHOMA MYELOMA .4 5-9 0. 90.9 20-24 0. gender. National Cancer Institute. race and type of leukemia.4 percent for children under 5 • CLL: 74.3 1. Relapse indicates return of the cancer cells and the return of other signs and symptoms of the disease. Treatment of Leukemia The aim of treatment is to bring about a complete remission. For acute leukemia.
Zuelzer WW. 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. Implications of long-term survivals in acute stem cell leukemia of childhood treated with composite cyclic therapy.420 deaths from ALL.470 Table 4: Source: Cancer Facts & Figures 2007.020 240 3. National Cancer Institute. Epidemiology and End Results).970 250 2.500 deaths from CLL and 1.710 9.320 males and 9. 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.390 additional deaths.390 21. Unclassified forms of leukemia will account for 6.320 Female 600 1. American Cancer Society. In 2007. 1975-2004.420 4. Hispanics with leukemia who are under the age of 25 had the highest mortality rates from the disease between 1990 and 1999.680 12.940 3. Deaths It is anticipated that approximately 21. leukemia causes more deaths than any other cancer among children and young adults under age 20. unclassified forms of leukemia Total Overall 1. leukemia will be the fifth most common cause of cancer deaths in men and the sixth most common in women. SEER (Surveillance. 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. In 2007.990 490 6.790 deaths in the United States will be attributed to leukemia in 2007: 12.500 8. Blood. 1964:24:477-494.470 females. about 515 children under the age of 14 are expected to die from leukemia.560 5. deaths from leukemia are expected to be distributed in the following numbers: In 2007.790 Male 820 2. in Children Under 15 Years of Age. 2007. Sources: 1. 2007. 2.990 deaths from AML and 490 deaths from CML. There will be an estimated 4. There will be an estimated 8. 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. Non-Hispanic whites diagnosed with leukemia over the age of 44 had the highest death rates during this period. LEUKEMIA LYMPHOMA MYELOMA page 9 . Cancer Statistics Review. 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.Five-Year Relative Survival Rates for Acute Lymphocytic Leukemia.
The incidence of Hodgkin lymphoma is consistently lower than that of non-Hodgkin lymphoma.7 percent of all cases of non-Hodgkin lymphoma will be diagnosed in children under 15 years of age this year. Living with Lymphoma In the United States in 2007.5 percent of all lymphomas diagnosed in 2007.000 for females.313 people living with Hodgkin lymphoma (active disease or in remission) and 405.710 Total 8. LEUKEMIA page 10 LYMPHOMA MYELOMA . New Cases About 71.Lymphoma Lymphoma is a general term for a group of cancers that originates in the lymphatic system. The groups are often classified as indolent or aggressive. Fifty-three percent of the blood cancers diagnosed are lymphomas. American Cancer Society.S. 2007 Type Hodgkin lymphoma Non-Hodgkin lymphoma Total Male 4. Incidence by Gender Table 5 illustrates the breakdown of incidence of lymphoma by gender. It is the sixth most common cause of cancer deaths in males and in females. and each has prognostic factors that categorize it as more or less favorable. 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. 2007. Hodgkin Lymphoma Hodgkin lymphoma is a specialized form of lymphoma and will represent about 11.000 at ages 20 to 24 for males and 1.3 per 100. eventually crowding out healthy cells and creating tumors that enlarge the lymph nodes or other sites in the body. Each histologic grouping is diagnosed and treated differently.Hodgkin lymphoma are higher in Americans of European descent than among those of African descent.000 for males and 38.000 for females. Incidence rates for Hodgkin lymphoma tend to be higher among males than among females. while 0. More than four percent of all cases of Hodgkin lymphoma diagnosed in 2007 will be in children under 15 years of age.380 Americans will be diagnosed with lymphoma in 2007 (8. including the presence of an abnormal cell called the ReedSternberg cell (a large. 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.190 63. incidence rates for non. New Cases of Lymphoma by Gender.9 per 100.190 cases of Hodgkin lymphoma and 63.8 percent.670 Female 3. the difference was small. malignant cell found in Hodgkin lymphoma tissues). Lymphoma results when a lymphocyte (a type of white blood cell) undergoes a malignant change and begins to multiply.470 34. Hodgkin lymphoma has characteristics that distinguish it from all other cancers of the lymphatic system. Non-Hodgkin lymphoma is the fifth most common cancer in males and females in the United States.990 32. Immune suppression plays a role in some patients.200 38.190 71.6 per 100.190 cases of non-Hodgkin lymphoma). The bacterium Helicobacter pylori is associated with the development of lymphoma in the stomach wall. or low.953 people living with nonHodgkin lymphoma for a total of 544. an average annual percentage increase of 2. The reasons for the development of non-Hodgkin lymphoma are not certain. Age-specific incidence rates of non-Hodgkin lymphoma are 2.720 28.9 per 100. In 2004.266 members of the U. Both Hodgkin and non-Hodgkin lymphomas are more common in males than in females. rose by 84 percent from 1975 to 2004. they are 52. population who are living with lymphoma. there are 138. The Epstein-Barr virus causes Burkitt’s lymphoma in Africa. By ages 60 to 64. intermediate and high grade.380 Table 5: Source: Cancer Facts & Figures 2007. in general whites have higher incidence rates than blacks. After 50 to 54 years of age. Persons infected with the human immunodeficiency virus (HIV) have a much higher risk of developing lymphoma. These risk factors explain only a small proportion of cases.
followed closely by Hispanic children of all races (24. In the United States. Hodgkin lymphoma incidence rates are higher in adolescents and young adults than in adults in their middle years. night sweats. the highest incidence of non-Hodgkin lymphoma is in Asian/Pacific islanders. armpit. armpit or groin. The incidence in this group decreased almost steadily and significantly between 1975 and 1999.000 children in 2004.8 percent for all races in 1996-2003. The rate increases more than 18 times to 45. In children from 0 to 19 years of age. Treatment Hodgkin lymphoma is often treated with radiation and chemotherapy. groin or in the abdomen.5 percent. Signs and Symptoms Signs and symptoms of Hodgkin lymphoma include painless swelling of lymph nodes in the neck. widespread disease requires chemotherapy or chemotherapy and/or monoclonal antibody therapy with radiation. The five-year relative survival rate for non-Hodgkin lymphoma patients has risen from 31 percent in whites in 1960-1963 to 63. persistent fatigue.5/1 million population). Incidence in Adults The incidence of non-Hodgkin lymphoma increases with age.070 from Hodgkin lymphoma).1 per 100. It is rarest among American Indian/ Alaskan native children. It has remained fairly constant since 1999.Among women. indigestion and abdominal pain. about 10. Five-year relative survival is now 95 percent for Hodgkin lymphoma in children aged 0 to 14 years. Treatment for non-Hodgkin lymphoma sometimes includes vaccines and other forms of immunotherapy. depending on the tumor size. Non-Hodgkin lymphoma is the ninth most common cause of cancer death in males and the seventh in females in the United States. About 2.0/1 million population).9 percent). The most common early sign of other forms of lymphoma is also painless swelling of the lymph nodes – usually in the neck. localized non-Hodgkin lymphoma is sometimes treated with radiation. Even in the mid-1970s. From ages 15 to 19.1 cases per 100. loss of appetite and bone pain. Symptoms also often include fever. Deaths An estimated 19.730 persons will die from lymphoma in the United States in 2007 (18. 1. In children up to age 14 years. Survival for Adults Hodgkin lymphoma is now considered to be one of the most curable forms of cancer. following leukemia (26.4 cases per 100. Incidence in Children The incidence of Hodgkin lymphoma among people under 20 years of age was 1. lymphomas are most commonly diagnosed in whites (24.8 percent) and neoplasms of the brain and other nervous tissue (17. the highest incidence of non-Hodgkin lymphoma is in non-Hispanic whites.660 from non-Hodgkin lymphoma. Early stage.000 people occur in 20. and non-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. 3. most children with nonHodgkin lymphoma did not live five years after diagnosis. Survival for Children Five-year relative survival is 95. recurrent high fever. Adolescents are more commonly diagnosed with Hodgkin lymphoma than young children.000 by ages 60 to 64. comprising nearly 5 percent of all cancers diagnosed. Radiation. 4. In children under 20 years of age. and more than 46-fold to 112. LEUKEMIA LYMPHOMA MYELOMA page 11 .to 24year-old individuals.2 percent for Hodgkin lymphoma in people under 20 years of age.5 percent. Non-Hodgkin lymphoma is the fifth most common cancer in Hispanics. chemotherapy or both may result in cures for most patients with Hodgkin lymphoma. five-year relative survival for non-Hodgkin lymphoma is now 83.1 cases per 100. cell type and location of the lymphoma.400 children under the age of 15 will be diagnosed with cancer in 2007. Hispanics of all races have the second highest incidence rates of non-Hodgkin lymphoma after whites. excessive tiredness. Death rates have been declining for Hodgkin lymphoma patients since the mid-1970s. troublesome itching and weight loss. Lymphomas (Hodgkin lymphoma.5 percent) are the third most common cancers in children. This represents a significant improvement in the rate of recovery.000 persons at ages 80 to 84. sweating at night. and is the eighth most common cause of cancer death in that group.
660 19.730 Male 770 9.0 0.8 3.9 4.0 20 10 0 0.0 100. 2000-2004 110 100 90 80 Incidence (per 100.4 4.4 2.6 32.000) 70 60 50 40 30 22.5 10.000) 5 4 3 2 1 0 0.2 1.Age-Specific Incidence Rates for Hodgkin Lymphoma.4 2. National Cancer Institute. Epidemiology and End Results) Cancer Statistics Review 1975-2004.070 18.3 4.1 4.360 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.2 4.9 1.060 9.4 2. National Cancer Institute.4 15.0 2.600 10. Epidemiology and End Results) Cancer Statistics Review 1975-2004. Table 6: Source: SEER (Surveillance.1 63.1 0.370 Female 300 9. Epidemiology and End Results) Cancer Statistics Review 1975-2004.1 3. 2007.4 80. 2007.0 45.1 0. 2007. 2000-2004 6 Incidence (per 100. *<16 cases per time interval.0 3.1 3. LEUKEMIA page 12 LYMPHOMA MYELOMA .4 2. * <16 cases for time interval.9 7. Age-Specific Incidence Rates for Non-Hodgkin Lymphoma.8 112. American Cancer Society. 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 1.8 4. National Cancer Institute.6 0.8 2.1 102.9 3.5 <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. 2007.0 1.4 3.
Usually. a B lymphocyte.4 33.424 people in the United States are living with myeloma. especially.790 deaths from myeloma are anticipated this year.000 to 3. *<16 cases for each age interval.2/100.1 21.940 women) new cases of myeloma will be diagnosed in the United States in 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. Sixty percent of those were diagnosed with the disease within the past four years. 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. Patients may have anemia.900 (10. approximately double. Total survival for white males. The U.8 14. especially in the marrow. Epidemiology and End Results) Cancer Statistics Review 1975-2004.000). 15-19. Malignant plasma cells produce an abnormal protein called monoclonal immunoglobulin.1 28.1 0.000). but it is the most difficult blood cancer to treat successfully. Treatment Chemotherapy for myeloma has led to sustained remissions in some patients. Lenalidomide is approved by the FDA in combination with dexamethasone for the treatment of myeloma patients who have received at least one prior therapy. has been increasing. median age at death from multiple myeloma is 74. the cell that forms plasma cells. At times. and it rarely occurs in people under age 45. Figure 9: Source: SEER (Surveillance. myeloma was the 10th most commonly diagnosed cancer among African-American men and women. Age-Specific Incidence Rates for Myeloma. New Cases An estimated 19.1 5.000) for all racial and ethnic groups. Living with Myeloma An estimated 60.000) is 56 percent higher than for women (4. Fractures may occur as a result of the weakened bones.9 9. causing pain and crowding out normal blood cell production. Approximately 3 percent of all cancer-related deaths among AfricanAmericans in 2000-2004 were from myeloma. LEUKEMIA LYMPHOMA MYELOMA page 13 . 10-14.1/100. the patient’s own stem cells are used (autologous stem cell infusion).000). The highest rates are found in black men 80 to 84 years of age and older (105/100.S. • The median age at diagnosis for African-Americans is 67. • Americans of African descent have a much higher incidence rate.0 37.4 35. National Cancer Institute. but primarily in the bone marrow. Thalidomide is approved by the FDA for use in treating newly diagnosed myeloma. tire more easily and feel weak. SEER 17 areas (<1. From 2000 to 2004.7 1. Treatment may include intensive chemotherapy followed by stem cell transplantation to restore normal blood cell production. 1-4. It is 71 for African-Americans. Bortezomib has been approved for treating myeloma in patients who have had at least two prior therapies.3 0. a type of white blood cell found in many tissues of the body.5/100.000) of myeloma than those of European descent (5. • The median age at diagnosis is 70.5 3. Deaths Approximately 10.000) 40 30 20 10 0 0-24 0. 5-9. two or three drugs are used simultaneously. 20-24). It grows continuously and forms masses of plasma cells. The mortality rate from myeloma for people of African descent is more than double the rate for whites (7. 2000-2004 Incidence (per 100. destroying normal bone tissue. becomes malignant. (11. 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.Myeloma Myeloma is a cancer of the plasma cells.1 Signs and Symptoms Often the first symptom of myeloma is bone pain caused by the effects of myeloma cells in the marrow.3/100. The onset of myeloma interferes with normal production of antibodies and makes myeloma patients susceptible to infections. Treatment is aimed at slowing progress of the disease.960 men and 8. Myeloma was the 10th most common cause of cancer deaths for women in 2000-2004. • The incidence rate in men (7/100. 2007.5/100. In myeloma. Recurrent infections may be an early sign of the disease.
7 24. Epidemiology and End Results) Cancer Statistics Review 1975-2004.2 2.4 11.1 2.) Table 9: Source: SEER (Surveillance.1 Table 10: Source: SEER (Surveillance. National Cancer Institute.1 3.2 14.1 11. for Whites.000 Population (2000-2004) Type Leukemia Non-Hodgkin lymphoma Hodgkin lymphoma Myeloma Overall 12. Epidemiology and End Results) Cancer Statistics Review 1975-2004.9 5. for Blacks.6 2.6 Female 9. Rates are per 100. (Based on SEER 17 areas.000 Population (2000-2004) Type Leukemia Non-Hodgkin lymphoma Hodgkin lymphoma Myeloma Overall 10.9 2.6 Male 16. National Cancer Institute.9 17.7 5. 2007.8 20. Incidence Rates by Gender.Incidence Rates: Leukemia.1 9.5 Incidence Rates by Gender. Hodgkin and non-Hodgkin lymphoma and myeloma use figures from 2000-2004. All Races. Epidemiology and End Results) Cancer Statistics Review 1975-2004. (Based on SEER 17 areas.3 Male 13.4 4.5 Table 8: Source: SEER (Surveillance. the most recent available. per 100.0 23.2 6. Lymphoma and Myeloma The following tables showing incidence rates for leukemia. 2007.3 2.2 Male 16.) Incidence Rates by Gender.5 16.6 4.3 2. (Based on SEER 17 areas. per 100. National Cancer Institute. 2007.0 7.8 14.) LEUKEMIA page 14 LYMPHOMA MYELOMA .0 2.2 3.0 Female 9.000 Population (2000-2004) Type Leukemia Non-Hodgkin lymphoma Hodgkin lymphoma Myeloma Overall 12.3 19.000 population and are age-adjusted to the 2000 population.0 Female 8. per 100.2 18.
1969-2004. Centers for Disease Control and Prevention. National Center for Health Statistics.S.Estimated New Cases of Blood Cancers by Site.610 150 2.830 240 230 60 * 1. 2007 State Leukemia Non-Hodgkin Lymphoma Myeloma Hodgkin Lymphoma*** Estimated Deaths from Blood Cancers by Site.160 1.160 140 50 360 440 170 320 * 18.390 1. ***Hodgkin lymphoma estimates are not available for 2007. Used with permission.880 240 250 50 50 1. American Cancer Society.070 80 330 70 480 1. by State. CA A Cancer Journal for Clinicians. 2007. **State estimates may not add up to U. and additional data supplied by the American Cancer Society.300 470 90 100 750 430 300 220 290 310 110 320 420 660 350 170 500 80 110 130 90 600 120 1.410 130 50 500 490 130 490 * 21.240 740 80 1.670 1.680 920 340 890 170 290 330 190 1. The method of derivation.410 560 * 740 230 230 930 70 300 50 350 1. and additional data supplied by the American Cancer Society based on data from the U. numbers are small and NCI and ACS are having difficulty fitting them into the Pickle et al.330 260 780 180 1.710 570 500 2.170 480 1.140 60 260 80 410 1.660 210 * 190 120 1. total because of rounding and exclusion of estimates that are fewer than 50 cases.610 670 610 110 60 3. They cannot be compared with previous years’ estimates to determine cancer incidence trends. 2006. **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. total because of rounding and exclusion of estimates that are fewer than 50 cases.530 1. *Estimate is fewer than 50 cases.. 2007.520 310 3.130 300 80 900 960 300 1. American Cancer Society.030 910 620 420 680 680 250 630 1. is described by Pickle et al.300 110 63. Note: These estimates are offered as a rough guide and should be interpreted with caution.560 770 890 3.500 430 1. January/February 2007.S.080 1. LEUKEMIA LYMPHOMA MYELOMA page 15 .250 1. Numbers are rounded to the nearest 10.360 960 170 220 2.360 610 * 950 290 260 1. 2007 State Leukemia Non-Hodgkin Lymphoma Myeloma Hodgkin Lymphoma Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Dist.540 1.370 250 280 2.550 * * * * *20 * * * * 60 * * * 50 * * * * * * * * * * * * * * * * * * 70 * * 50 * * 60 * * * * 80 * * * * * * * 390 Table 11: Sources: Cancer Facts & Figures 2007. Numbers are rounded to the nearest 10.510 500 60 70 900 380 220 160 280 430 100 370 460 730 310 170 400 70 110 120 80 650 120 1.140 380 140 1.070 Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Dist. 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. *Estimate is fewer than 50 cases.080 600 7.200 350 4.010 1.050 140 140 * * 680 310 * 50 440 240 130 120 170 180 60 220 250 420 190 110 240 50 70 80 50 270 70 650 360 * 460 120 160 550 * 200 * 270 720 70 * 250 220 70 200 * 10.150 290 270 70 * 1.370 100 * 430 380 130 350 * 19. which is new for 2007.180 4.S. 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. Mortality Public Use Data Tapes. by State.790 330 * 320 200 1. Used with permission. model (see below).030 570 * 610 210 360 1.190 290 * 280 200 1.040 70 44.190 880 870 170 100 4.310 800 600 900 920 330 1.550 2. Note: These estimates are offered as a rough guide and should be interpreted with caution.260 220 400 420 290 2. Table 12: Sources: Cancer Facts & Figures 2007.070 110 1.240 170 550 130 800 3.
The data can be extrapolated for the entire United States by multiplying by the population ratio. Incidence rates can be calculated based on a number of factors such as age. it is the number of new cases per standard unit of population during the time period. The relative survival rate is a comparison of survival to a person who is free of the disease. This change means that the 2007 incidence estimates are not comparable with previous estimates for determining cancer incidence trends. state-by-state data for incidence of Hodgkin lymphoma are not available because these numbers are so small. Prevalence may be calculated in a number of different ways.” as per SEER table I-21. The SEER (17 region) data cover only about 26 percent of the U.) Prevalence is the estimated number of people alive on a certain date in a population who previously had a diagnosis of the disease. It includes new (incidence) and preexisting cases and is a function of both past incidence and survival. the American Cancer Society changed its method of estimating cancer incidence. Because of reporting delays from some of the SEER regions.S. 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. race or sex. The description of the methods used was published in Pickle et al. if a person is initially diagnosed with melanoma and later develops leukemia. in comparison to the 2002 SEER report.. January/February 2007. population. In some prevalence statistics. his or her survival with leukemia may not be counted in leukemia prevalence statistics. based on the “first invasive tumor for each cancer site diagnosed during the previous 29 years (1975-2003). prevalence numbers reported may vary depending upon the method used to determine them. Thus. Because of changes in the information — such as racial classification — gathered in the 2000 U.S. It considers deaths from all causes. only the first diagnosed cancer counts. The data presented in this report are an extrapolation or estimate of the number of cases reported by the 17 Surveillance. no matter how long ago that diagnosis was. especially in looking at populations in which individuals have had more than one type of cancer. survival and mortality have been revised. CA A Cancer Journal for Clinicians. 2007.Notes and Definitions Notes The United States does not have a nationwide reporting system or registry for blood cancers. Thus. but these figures do not take into account differences in geography. 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. When expressed as a rate. the data presented in the 2007 SEER report placed online on April 15. race and ethnicity in various regions and region-specific health risks. may be incomplete in some cases and the data may reflect adjustments that anticipate changes that will occur once the actual data are received.” We are using the “29-year limited duration” prevalence figures. This year. population) that belong to the National Program of Cancer Registries. so the exact number of cases is not known. Relative survival rate is an estimate of the percentage of patients who would be expected to survive the effects of the cancer. in some cases fewer than 17 SEER regions) and death data from the National Center for Health Statistics. Census.S. cancer or otherwise. LEUKEMIA page 16 LYMPHOMA MYELOMA . Because of this change in method. (Observed survival is the actual percentage of patients still alive at some specified time after diagnosis of cancer. Bureau of the Census’ 2000 population data for that region. 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. Definitions Incidence is the number of newly diagnosed cases for a specific cancer or for all cancers combined during a specific time period. 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. Epidemiology and End Results Program (SEER) regions (or. The specified date is 1/1/2004 for the prevalence estimates. 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.S. mostly upward. estimates of cancer incidence. In this report. 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.
Ries LAG (eds). Bethesda.” O’Leary M. O’Leary M. Barr R. Ross J. National Cancer Institute. http://www. Krapcho M. Bleyer A. 1975-2004. Bethesda. No.cancer. Bleyer A. 2007. Edwards BK (eds). Cheson B. “A New Method of Estimating United States and State-Level Cancer Incidence Counts for the Current Calendar Year. O’Leary M. No. Keller F. Barr R. http://caonline. MD.” Pickle LW. Bleyer A. National Cancer Institute. pp. Atlanta: American Cancer Society. 2007. NIH Pub. pp. SEER (Surveillance. 065767. 2006. NIH Pub. Sheaffer J.” Bleyer A. posted to the SEER Web site 2007. “Leukemias. Mariotto A. 20-37.Citations Source Citations Cancer Facts & Figures 2007. http://seer. Horner MJ. MD. 57. 39-51. O’Leary M. “Cancer Statistics. 2006.gov/csr/1975_2004/ LEUKEMIA LYMPHOMA MYELOMA page 17 . “Lymphomas and Reticuloendothelial Neoplasms. NIH Pub. MD. 25-38. National Cancer Institute. The Oncologist Vol. 2007. Shu X-O. 174. Ries LAG (eds). Tiwari RC. Epidemiology. 06-5767. Howlader N. Including SEER Incidence and Survival: 1975-2000. based on November 2006 SEER data submission.” Hayat MJ. Trends. In Cancer Epidemiology in Older Adolescents and Young Adults 15 to 29 Years of Age. 30-42. Reichman M. and End Results) Cancer Statistics Review. and Multiple Primary Cancer Analyses from the Surveillance. 2006.com/cgi/content/full/12/1/20. National Cancer Institute. Feuer EJ. 2007. Hachey M. January. In Cancer Epidemiology in Older Adolescents and Young Adults 15 to 29 Years of Age.TheOncologist. In Cancer Epidemiology in Older Adolescents and Young Adults 15 to 29 Years of Age. Atlanta: American Cancer Society. Bethesda. Stock W. “Highlights and Challenges. 12. pp. Zou Z. Epidemiology. pp. Ries LAG (eds). 065767. Feuer EJ. Howlander N. CA A Cancer Journal for Clinicians Vol. Barr R. Clegg L. Nachman J. Melbert D. and End Results (SEER) Program. Reichman ME. Ward E. Eisner MP. January/February. Howe HL. No. Bethesda. Including SEER Incidence and Survival: 1975-2000. Hao Y.amcancersoc. Cancer Facts & Figures for African Americans 2007-2008. Ries LAG. p. Edwards BK. Miller BA.org/cgi/content/full/57/1/30.” Mattano L Jr. MD. Jemal A. Including SEER Incidence and Survival: 1975-2000. Barr R.
Since the first funding in 1954. Translational Research Program The Translational Research Program provides early-stage support for research on leukemia. 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 .6 million annually on research. leading to better survival rates and prevention measures for patients.000 over five years. Career Development Program The Career Development Program supports promising young scientists (Scholars. The Grant Review Process Scientists and physician-scientists who are experts in the field of leukemia. for a total of $600. 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. and improve the quality of life of patients and their families. lymphoma and myeloma.000 over five years. 3) Translational Research Program. Translational Research • Scholars in Clinical Research are awarded $110. • Special Fellows are awarded $60. The participating scientists may be at different institutions or from any country. the Society’s grant programs are among the most prestigious in the fields of blood cancers. The SCOR program brings together research teams working in complementary areas. The Society is a nonprofit organization that relies on the generosity of individual and corporate contributions to advance its mission.000 over three years. 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. lymphoma. to a total cost of $6. 2) CDP-clinical research. lymphoma and myeloma that is intended to advance treatment.000 a year for a total of $180. each focused on the discovery of new approaches to benefit patients or those at risk for developing leukemia. Research Research Grant Programs The Society’s research programs are based on the belief that all scientifically sound approaches toward a cure for. 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 Specialized Center of Research (SCOR) in Leukemia. the Society has awarded more than $550 million in research grants.000 over three years.000 a year for a total of $550.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. Translational Research Awards are made for an initial three-year period. treatment or prevention of leukemia.25 million per year over a five-year period. The SCOR grants also support scientific core laboratories to provide access to innovative technology if required by the participating research programs. Each SCOR is funded up to $1. Now supporting $61.000. Funding for two additional years may be provided for highly promising projects that are entering phase I clinical trial.000 per year for three years. • Special Fellows in Clinical Research are awarded $60. Research grants are awarded in three program areas: Career Development.000 a year for a total of $150.000 a year for a total of $180. leukemia. Thus. They are: 1) Career Development Program (CDP)-basic research. Awards up to $200.000 a year for a total of $550. lymphoma and myeloma research comprise four review subcomittees. We offer a wide variety of programs and services in support of our mission: Cure leukemia. Translational Research and the Specialized Center of Research (SCOR). lymphoma and myeloma should be encouraged worldwide. Awards go to those groups that best demonstrate the synergy that will occur from their close interaction. or control of. The program is expected to generate new knowledge and breakthrough discoveries. diagnosis or prevention in the near term.000 over three years. lymphoma or myeloma.25 million. • Fellows are awarded $50. Hodgkin’s disease and myeloma.
The Society also hosts numerous teleconferences and Webcasts.LLS. including support groups.org. and click “Live Help. Guided by two volunteer oncology health professionals. Information on registration for these free events can be accessed at www. Information Resource Center (IRC) The Society strives to be the world’s foremost source of information on leukemia. The user has the opportunity to create personalized pages with identified interests. This support should advance the understanding. The Society funds several Focused Workshops each year on important topics relevant to hematological malignancies. myeloma. clinical trials and offer guidance on coping. Family Support Group locations. These include the Stohlman Scholar Symposium. Co-Pay Assistance Program Patients with AML.org or faxing to (914) 949-6691 or contacting the Research Department at (914) 949-5213. 2007 the Society will have 379 active grantees at 116 institutions in the United States and abroad. and applications for the Society’s three research programs may be obtained by visiting www. from 10:00 a. First Connection: This program links newly diagnosed patients to a peer volunteer who has experienced a similar diagnosis. myelodysplastic syndromes (MDS) and other blood cancers. lymphoma. Professional Education The Society serves the continuing educational needs of the medical and research community through professional symposia offered throughout the year. The educational program offers varying formats to facilitate the exchange of information and ideas on the newest developments in cancer research and treatment.m.m. audio. The IRC is a worldwide link to information and resources useful to patients. Educational Materials An extensive collection of free educational materials are offered to patients and health professionals. 9 a.LLS.org. is held each December on the Friday immediately before the American Society of Hematology meeting. 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. friends and healthcare professionals. Teleconferences and Webcasts The Society sponsors more than 25 educational teleconferences and Webcasts each year on topics of interest to patients and caregivers.m. They are available to talk one-onone. The site features a comprehensive overview of blood cancers. where medical professionals share the latest research findings. Monday through Friday. brochures and videos through the IRC and local Society chapters. and encourages greater communication among patients.org or by or emailing researchprograms@LLS. the Translational Research Grant Progress Review Meeting and the SCOR Progress Review Meeting. Much of the content of these materials is available to view and download at www. As of June 30. to 5:00 p. the Society’s programs and services. podcasts and Webcast archives of these programs are available at www. information about our peer-to-peer program First Connection and other programs. Each year. Patients.LLS. families and professionals may call the IRC toll free at (800) 955-4572 in addition to corresponding by email at infocenter@LLS. Other meetings are held for the Society’s grantees. Information specialists are oncology social workers and health educators who provide callers with current information on blood cancers. sponsored by the Society. ET.m. Guidelines. These offices conduct lifeenhancing patient services.important projects to advance the Society’s mission. You may also chat online with an information specialist. their families and healthcare professionals. ET.org.LLS. The Society’s Web Site The Society’s Web site.org. serves a wide variety of education and information needs.LLS. www. The Annual Research Symposium. to 6 p. A trained patient volunteer currently in remission phones the new patient to share information and support. www. lymphoma.LLS. treatment and prevention of leukemia. It is continually being updated and expanded to support and promote the Society’s mission.org. treatments. instructions. each group provides information and support.org. LEUKEMIA LYMPHOMA MYELOMA page 19 .org.org/copay.” Chapter Programs: Family Support Groups: The Society has developed more than 360 Family Support Groups at 68 chapters. families. peer counseling and patient financial aid. call (877) LLS-COPAY ( 557-2672) or email copay@LLS.LLS. www. Patient Services The Society has a network of 68 chapters throughout the United States and Canada. on the Society’s Web site. Patients needing assistance may apply on the Society’s Web site. the Society distributes more than 1 million booklets. lymphoma and myeloma.
The Path to Progress: Clinical Trials in Blood Cancers: This program provides patients. 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. This nursing education program provides an overview of CML. patients and school personnel to assure youngsters a smooth transition from active treatment back to school. treatments. In 2002. This program is being sponsored by an unrestricted education grant from Novartis Oncology. emerging therapies and side effects and addresses the unique challenges of nursing management of these patients. New Directions in Myeloma Therapy: This program presents an overview of myeloma. To date. 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. and offers numerous resources that can assist childhood cancer survivors to flourish in the school environment posttreatment.000 and has become a potent voice in public policy deliberations. this education program discusses possible emotional and cognitive short. New insights. that program has funded some $30 million in additional blood cancer research.LLS. CML Issues and Insights: A Nursing Education Program on Chronic Myelogenous Leukemia. This program is provided through an unrestricted educational grant from Millennium Pharmaceuticals. On the state level. treatments and future directions for NHL are also discussed. 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. parents. drugs and various treatments not covered by insurance.and long-term effects that children may experience after treatment. The Society has identified key issues that currently shape its advocacy agenda. This program is also accessible as a Webcast at www. 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. Advocacy Since 1994. Department of Defense’s medical research program. representing to policy makers at all levels of government the healthcare quality concerns and medical research interests of patients and their families. staging and classification of nonHodgkin lymphoma (NHL). LEUKEMIA page 20 LYMPHOMA MYELOMA . families and healthcare professionals with a clear description of what clinical trials are. The patient education program was funded at $18 million through 2007.S. the Society’s advocacy program has been a strong voice in Washington. Patient financial aid funds are subject to availability. videos and other materials to aid the process are available through all local chapters. DC. In 2001.org and is being sponsored by a generous. the Society successfully lobbied Congress to institute a blood cancer research initiative as part of the U. reimbursement of up to $500 per year helps cover the costs of transportation. treatments. This program is made possible by the Lance Armstrong Foundation. Meet the Expert on Non-Hodgkin Lymphoma: This program presents basic information on terminology. unrestricted educational grant from Genentech BioOncology and Biogen Idec Inc. Through the Patient Financial Aid Program.Patient Financial Aid Program: For more than 31 years. emerging therapies and managing side effects and how to find emotional support when living with the illness. That network now numbers more than 35. risk factors. This Society program is being supported by Celgene Corporation and Millennium Pharmaceuticals. 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. It is supported by Amgen Oncology. lymphoma and myeloma. Working through chapters across the country. how cancer drugs are developed and what the emerging treatment options are for leukemia. Welcome Back: Facilitating the Return to School for Children with Cancer: A new addition to The Trish Greene Back to School Program. providing additional support for blood cancer patients and their families nationwide. The Trish Greene Back to School Program for Children with Cancer: This program is designed to increase communication among healthcare professionals. Printed literature. diagnosis. 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.
D.Acknowledgements Additional data from SEER*Stat Databases at http://www. with the understanding that the Society is not engaged in rendering medical or other professional services. of the American Cancer Society (ACS). and Rebecca Siegel. . provided ACS’s state-by-state statistics on myeloma and Hodgkin lymphoma. for compilation of data for this publication. Milton Eisner of SEER.gov.seer.. Ph. The Leukemia & Lymphoma Society extends special thanks to Myrna Watanabe. NCI. It is distributed as a public service by The Leukemia & Lymphoma Society Inc. provided statistical assistance.cancer. This publication is designed to provide information in regard to the subject matter covered.
lymphoma.4572 www. and improve the quality of life of patients and their families. New York 10605 Tel: 888.Home Office 1311 Mamaroneck Avenue.LLS.org Our mission: Cure leukemia.955. corporate and foundation contributions to advance its mission.HELP. PS80 35M 6/07 . The Society is a nonprofit organization that relies on the generosity of individual.LLS Information Resource Center (IRC): 800. Hodgkin’s disease and myeloma. Suite 310 White Plains.
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