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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.
• Non-Hodgkin lymphoma is the fifth most common cancer in the United States. This year. Highlights from the Report Include: New Cases • An estimated 135. Deaths • Leukemia. nonacute myelogenous and monocytic leukemias Lymphoma: • There are 544. Hodgkin and non-Hodgkin lymphoma. the likelihood of dying from most leukemias*. • In 2007. Leukemia. • Every five minutes. Epidemiology and End Results Program. • This year. and its age-adjusted incidence rose by nearly 84 percent from 1975 to 2004.1975-1977 vs. 405. The data within Facts 2007-2008 reflect the most recent statistics available from SEER.3 percent of the deaths from cancer in 2007 based on the 559.310 people in the United States this year. is a compilation of the most recent data on leukemia. 71. lymphoma and myeloma are cancers that originate in the bone marrow or lymphatic tissues as the result of an acquired genetic injury to the DNA of a single cell. 18. *Myeloma Biology and Management. in April 2007. LEUKEMIA LYMPHOMA MYELOMA page 1 .659 people in the United States who are either living with or are in remission from 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 218.444.730 people will die from lymphoma (1. or nearly six people every hour. 1975-2004. 21.520 people in the United States will be diagnosed with leukemia.424 people living today with myeloma.920 new cancer cases diagnosed in the United States this year.190 cases of non-Hodgkin).070 from Hodgkin.380 new cases of lymphoma will be diagnosed in the United States (8. Cancer Statistics Review 1975-2004 (see Notes. This statistic represents 143 people each day. National Cancer Institute. Survival • An estimated 823. 63. someone dies from a blood cancer.790 people will die of leukemia. • Thirty-two percent more males are living with leukemia than females. From 1975 to 2004. page 16).660 from non-Hodgkin). • This year. an annual publication. 1960-1963 1975-1977 1996-2003 Figure 1: Sources: SEER (Surveillance.240 people will be diagnosed with leukemia.4 percent of the 1. someone is diagnosed with a blood cancer. 2007 and SEER 19731993.190 cases of Hodgkin.650 total cancer-related deaths. These data were published online by SEER. • These blood cancers will account for 9. 19. • Leukemia causes more deaths than any other cancer among children and young adults under the age of 20. lymphoma and myeloma.953 either have or are in remission from non-Hodgkin lymphoma (NHL). National Cancer Institute. Mortality from the disease increased 24 percent. lymphoma and myeloma decreased from 1995 to 2004 (the last year data were available). and myeloma. Epidemiology and End Results) Cancer Statistics Review. This year.349 Americans are living with leukemia. The next SEER Cancer Statistics Review is expected to be published online in April 2008. the incidence of myeloma increased 8 percent. 1998. 19. • Eighty-six percent of myeloma cases occur in people aged 55 and over. the National Cancer Institute’s Surveillance.Executive Summary Facts 2007-2008. This abnormal accumulation interferes with the production of healthy blood cells. • In general. 2nd Edition.266 people living today with lymphoma. *except acute myelogenous leukemia (AML) and other.790 people will die from myeloma. which becomes malignant and multiplies continuously. lymphoma and myeloma will cause the deaths of an estimated 52. Oxford University Press. More males are diagnosed with leukemia and more males die of it than females. 10. 1996.313 either have or are in remission from Hodgkin lymphoma. 44.cancer.900 people will be diagnosed with myeloma.gov. • Every 10 minutes. Hodgkin and non-Hodgkin lymphoma and myeloma will account for nearly 9. Five-Year Relative Survival Rates 1960-1963 vs. www. 138. lymphoma and myeloma in 2007. • New cases of leukemia.seer. • In 2007. Myeloma: • • • • There are 60.
2007. which becomes abnormal (malignant) and multiplies continuously. usually a brother or sister with the same tissue type. especially for children. Patients with leukemia. studies suggest that two matched cord donors may result in a higher success rate in larger adults. 2007. However. myeloma and lymphoma are usually treated with chemotherapy. for which a parent rather than a sibling could be the donor. An allogeneic transplant uses blood or marrow stem cells from a normal donor. The technique is important. The blood or marrow stem cells are collected while the patient is in remission. usually in combinations of two or more drugs. The accumulation of malignant cells interferes with the body’s production of normal blood or immune cells and can result in severe anemia. slightly mismatched cord stem cell donors may be used quite successfully. The harvesting. Estimated New Cases (%) of Blood Cancers in 2007 Myeloma 15% Leukemia 33% Lymphoma 53% Treatment Chemotherapy and Radiotherapy: The use of chemotherapy (anticancer drugs). freezing and storing of cord blood have provided another source of stem cells for transplantation.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. (Numbers do not add up to 100% because of rounding. is largely responsible for the dramatic improvement in managing leukemia and lymphoma. especially in young 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. These diseases usually result from an acquired genetic injury to the DNA of a single cell. Research is being conducted to improve socalled “haploidentical” transplant. decreased ability to fight infections and a predisposition to bleeding. a search of the National Marrow Donor Program registry of tissue-typed volunteers could be made for a matched unrelated donor. The technique of harvesting stem cells from blood and cord blood has made transplantation available for more LEUKEMIA page 2 LYMPHOMA MYELOMA . 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. Syngeneic transplant describes the use of an identical twin as donor. Patients with acute lymphocytic leukemia (ALL). Autologous transplantation uses the patient’s own marrow stem cells and is technically not transplantation since another person is not the donor. Approximately 50 different drugs are now being used in the treatment of these diseases. lymphoma and myeloma. Such an approach would greatly lessen the proportion of children without a donor. Hodgkin and non-Hodgkin lymphoma and myeloma are cancers that originate in a cell in the bone marrow or lymphatic tissues. 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. Stem cells also circulate in large numbers in fetal blood and can be recovered from umbilical cord and placental blood after childbirth. The numbers of stem cells in cord blood are often insufficient for the needs Figure 2: Source: Cancer Facts & Figures. They are considered to be related cancers because they arise from cells with a common origin (the lymphohematopoietic stem cells) and with related functions. There are two major types of stem cell transplants: syngeneic and allogeneic. If a sibling is not available.) of larger adult patients. 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. In special instances. some types of Hodgkin lymphoma. American Cancer Society.
The protein is an enzyme in the family of tyrosine kinases. lymphoma or myeloma and permit the donor’s cells to be accepted by the temporarily immunodeficient recipient. Cancers (http://www. 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. Cancer survivors should see their primary care physicians for general health examinations and an oncologist for follow-up care related to cancer. In nonablative transplantation. Coordination between specialists and primary care physicians is essential to provide the best care possible. Some treatment centers have follow-up clinics that provide a comprehensive. donors of blood stem cells require special treatment to mobilize sufficient stem cells from marrow into their blood before cells are harvested. 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. Most follow-up clinics specialize in pediatric cancer survivors.childrensoncologygroup. and Young Adult LEUKEMIA LYMPHOMA MYELOMA page 3 . Identifying these biomarkers will allow researchers to develop tests that can predict what effects an individual is at risk of developing. few severe adverse effects on normal tissues and a very high response rate. but some follow adult cancer survivors. It has been made possible by more effective immunosuppressive drugs that are capable of preventing rejection of the donor’s cells without full intensity treatment of the patient’s immune system. Blood and cord blood transplants differ from marrow transplants principally in the source of the cells collected for transplant. the donor’s cells take hold and the patient’s leukemia. these cells can be harvested from the blood of a donor. Stem cells not only reside in the marrow but also circulate in the blood. To ensure there will be enough blood stem cells for successful transplantation. several important new drugs and new uses for existing drugs have greatly improved cure rates or remission duration for some patients with leukemia.org/). New Approaches to Treatment Several areas of research have resulted in new approaches to the treatment of leukemia. Over time. decreased side effects. is a source of stem cells for transplantation. identify recurrence of the disease and detect long-term or late effects.patients. as well as marrow. frozen and stored and later transplanted in the patient. 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. Regular examinations may include screening for cancer recurrence or the development of secondary cancer or other late effects of treatment. Development of New Drugs: In the past decade. or genetic factors that can increase susceptibility to certain effects. Adolescent. multi-disciplinary approach to monitoring and supporting cancer survivors. In standard stem cell transplantation. Follow-Up Care Regular medical follow-up enables doctors to assess the full effect of therapy. marrow and immune system. lymphoma or myeloma is attacked and suppressed by donor lymphocytes that form from the donor stem cells. Gleevec offers several dramatic advantages to patients: oral administration. lymphoma or myeloma can have an allogeneic transplant. Biomarkers could be high levels of certain substances in the body such as antibodies or hormones. “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. thereby allowing doctors to plan treatment accordingly. ablation of the recipient’s blood-cell forming and immune cells was the price that had to be paid to eradicate the leukemia. two second-generation agents. This “graft versus leukemia or lymphoma effect” can suppress (cure) the malignancy and is a prolonged (indefinite) form of immunotherapy. Because blood. Imatinib mesylate (Gleevec®) is now the drug of choice in newly diagnosed patients with chronic myelogenous leukemia (CML). This still experimental approach greatly lessens the early toxicity of transplantation and has extended the age at which recipients with leukemia. Follow-Up Guidelines: The Children’s Oncology Group has established Long-Term Follow-Up Guidelines for Survivors of Childhood. lymphoma and myeloma. making the procedure more tolerable. Cancer survivors should have physical examinations yearly or more often. It works by blocking the oncogeneencoded protein product that instigates the transformation to a leukemic cell. as needed. “Ablation” referred to wipingout the recipient’s cancer. the recipient’s blood cell and immune system are preserved. Although a minority of patients have developed resistance to the drug.
and enhances the specificity of treatment to minimize toxic effects on normal tissues. approved by the FDA for all types of MDS. but it can also induce remissions in some cases of acute leukemia. a less common type of chronic lymphocytic leukemia (CLL). In May 2006. Revlimid is approved by the FDA in combination with dexamethasone for the treatment of myeloma patients who have received at least one prior therapy. 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. Some patients with moderately severe. Velcade is approved by the FDA for treating people with myeloma who have had at least one prior therapy. PDGFR or KIT oncoproteins). 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®). and Decitabine (Dacogen®). Arsenic trioxide also adds to the drugs available to treat this subtype of acute leukemia. Azacitidine (Vidaza®). Gleevec is not only a very important new agent in the treatment of CML. Monoclonal antibodies have added to the arsenal of agents that are used for the treatment of patients with lymphoma and leukemia. Clofarabine (Clolar®). Immunotherapy: This is a treatment that uses immune cells or antibodies to fight the disease. vincristine (Oncovin®) and prednisone–therapy for diffuse large B-cell lymphoma. 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. but without this specific chromosome 5 abnormality. Other therapies in clinical research to treat MDS include arsenic trixoxide. symptomatic anemia have improvement in hemoglobin levels with this agent. kill unhealthy bone marrow cells and may help the bone marrow function more normally in MDS patients. principally. Monoclonal Antibody Therapy: Monoclonal antibodies are laboratory-produced proteins that can be infused into an appropriate patient. 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.dasatinib (Sprycel®)(approved by the U. 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). The treatment of hairy cell leukemia. Indeed. LEUKEMIA page 4 LYMPHOMA MYELOMA . lymphoma or myeloma. reducing the need for transfusions in some patients. farnesyl transferase inhibitors and reduced-intensity stem cell transplantation. a thalidomide derivative. Pentostatin is another effective drug that can be used in patients with hairy cell leukemia who do not respond to cladribine. Three types of immunotherapy are being explored: antibody treatment. doxorubicin (Adriamycin®). Early studies indicate the combination of arsenic trioxide and all-trans retinoic acid may be a further advance in the initiation of therapy. was approved by the FDA for newly diagnosed myeloma. although initially used in indolent lymphomas. however. Cladribine induces long-term remissions in nearly 90 percent of patients treated at diagnosis for one week. is being used to treat relapsed or refractory acute lymphocytic leukemia (ALL) in children who have received at least two prior therapies. Patients with more severe forms of MDS are very unlikely to respond to the agent. perhaps 20 percent of cases also derive benefit. are entering clinical use and can overcome this resistance in some cases. the most prevalent lymphoma subtype. thalidomide (Thalomid®). 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. cyclophosphamide. such as follicular lymphoma. Rituximab is an antibody directed at the target CD20 antigen on B-cell lymphoma cells.S. has improved dramatically with the introduction of cladribine. Alemtuzumab (Campath®) is a monoclonal antibody directed against the antigen CD52 found on T and B lymphocytes. Lenalidomide (Revlimid®). Rituximab has become an important agent to treat CD20-positive lymphocytic malignancies. suppresses the progression of leukemia. In patients with anemia. It is especially active against the lymphocytes in CLL. Food and Drug Administration [FDA] in 2006) and nilotinib (in clinical trials). in combination with dexamethasone. chronic eosinophilic leukemia (formerly hypereosinophilic syndrome). it has now become an important fifth drug in the R-CHOP–rituximab. Cell surface antigens have been given a cluster designation (CD) followed by a number. approved by the FDA in 2005. This drug is also being tested in clinical trials to treat adult acute leukemia and MDS. immune cell administration and vaccine development. thus rituximab is an anti-CD20 antibody.
This means that the vaccine induces an immune response against the cancer cells present in the patient. These antibodies are injected into the patient in the hope that the antibodies will latch on to the antigen on the cancer cells and destroy the cells. the infusion of the original marrow donor’s lymphocytes can re-induce remission. 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. This drug. In patients with CML who have relapsed after stem cell transplantation. LEUKEMIA LYMPHOMA MYELOMA page 5 . Two new and potentially important approaches include a) the application of RNA interference. b) a modality that uses molecules of RNA to silence complementary (DNA) genes. 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. gemtuzumab (Mylotarg®). In one approach. They deliver the toxic substance directly to the cancer cells. new forms of cancer therapy may be developed. In some approaches. is approved for older patients with AML who relapse after initial treatment. These cells are. Paradoxically. In another approach. In each case.Another antibody that has been approved for use by the FDA to treat certain patients with acute myelogenous leukemia (AML) is linked to a chemical toxin called calicheamicin. These types of vaccines would be used in patients who have small amounts of residual blood cancer after chemotherapy or stem cell transplantation. The goal of several new agents being studied is to decrease resistance to an important chemotherapy drug used in leukemia. cells are isolated in the laboratory and start making antibodies after insertion of the cancer antigen. or become. Monoclonal antibodies can also be linked to a radioactive isotope to target and kill specific cancer cells. These drugs have been approved to treat relapsed B-cell non-Hodgkin 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. An alternative strategy called molecular targeted drug development targets the oncoprotein. the patient’s immune cells would be treated in the laboratory to train them to attack the residual leukemia. drugs are designed to interfere with the oncoprotein and prevent its effect on the cell. Reversal of Multidrug Resistance: The malignant cells of patients have mechanisms that may allow them to escape the damaging effects of chemotherapy agents. gene therapy researchers are trying to modify an oncogene (BCR-ABL) that produces a protein that stimulates malignant cell growth. Vaccines are in clinical trials for types of acute and chronic leukemia. Patients with myeloma have also had remission re-induced by donor lymphocytes. lymphoma and myeloma. 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. lymphoma or myeloma cells. If the gene in the former case is an oncogene or the protein in the latter case is an oncoprotein. a technique that prepares small molecules in the laboratory that have the ability to inactivate proteins that cause disease. Vaccines: Experimental treatment vaccines are now being studied to treat certain types of lymphoma. DNA vaccines that contain the DNA that encodes the specific antigen are being tested. In studies of CML. myeloma and leukemia. Approaches to reversing multidrug resistance are under study. 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. These are called conjugated monoclonal antibodies. Examples of this treatment are the drugs ibritumomab (Zevalin®) and tositumomab and iodine I131 tositumomab (Bexxar®). and aptamer treatment. some vaccines are made from leukemic cells treated in test tubes to convert them to potent antigen-presenting cells. The goal is to extend the duration of remission achieved by remissioninduction therapy of various types. Studies of vaccines used in patients with follicular or indolent lymphoma have demonstrated an immune response. 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. Many cancer treatment vaccines under development are intended to induce antigen-specific antitumor immune responses. less responsive to therapy.
Epidemiology. more than half of all cases occur after age 67.4 percent of leukemias in children aged 0-19 are CML.240 new cases of leukemia will be diagnosed in the United States this year.501 50.790).240 Male 3.800 children. functionless cells in the marrow and blood. and End Results) Cancer Statistics Review 1975-2004. Anemia. Approximate U. New Cases An estimated 44. develops in virtually all leukemia patients. American Cancer Society. The terms myelogenous or lymphocytic denote the cell type involved.579 21. Estimated 29-Year L-D Prevalence Counts on 1/1/2004 by Duration.Leukemia Leukemia is a malignant disease (cancer) of the bone marrow and blood. Incidence by Gender Incidence rates* for all types of leukemia are higher among males than among females. • The most common form of leukemia in children is acute lymphocytic leukemia (ALL). 2007. Only 2. Leukemia is expected to strike more than 10 times as many adults as children in 2007. aged 0-19. functional cells to be made.000 2. males are expected to account for 56 percent of the new cases of leukemia.410 4. 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. 2007.200 15. Statistical Research and Applications Branch. (About 40. based on the November 2006 SEER data submission. Prevalence of the Four Major Leukemias as of Jan. each of which can be acute or chronic. LEUKEMIA page 6 LYMPHOMA MYELOMA . DCCPS.960 7. It is characterized by the uncontrolled accumulation of blood cells. NCI.720 44. Chronic leukemias account for 7 percent more of the cases than acute leukemias.350 2. 1.440 Table 2: Sources: SEER (Surveillance. Prevalence database: U. Surveillance Research Program. a deficiency of red cells.570 5.) • The most common types of leukemia in adults are acute myelogenous leukemia (AML) and chronic lymphocytic leukemia (CLL).440 adults compared with 3. The four major types of leukemia are shown in Table 1.140 6.570 19. red blood cells and white blood cells. The lack of normal white cells impairs the body’s ability to fight infections.000 population. The marrow often no longer produces enough normal platelets. Acute leukemia is a rapidly progressing disease that results in the accumulation of immature. 2004 Type Chronic lymphocytic leukemia Chronic myelogenous leukemia Acute lymphocytic leukemia Acute myelogenous leukemia Prevalence* 95. • Most cases of leukemia occur in older adults. released April 2007.150 24.S.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 5.060 8. Leukemia is divided into four categories: myelogenous or lymphocytic.800 Female 2.060 2. In 2007. *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. The incidence rates are usually presented as a specific number per 100.570 3. • About 33 percent of cancers in children aged 0-14 years are leukemia • Most cases of chronic myelogenous leukemia (CML) occur in adults. Table 3: Source: Cancer Facts & Figures 2007.189 27.380 6. National Cancer Institute. A shortage of platelets results in bruising and easy bleeding. *Note: Incidence rates are the number of new cases in a given year not counting the preexisting cases. Nearly 54 percent of the new cases of this disease will occur among children in 2007 (about 2. and SEER Program. Chronic leukemia progresses more slowly and allows greater numbers of more mature.659 people in the United States are living with leukemia.340 13.S.
000 population. They do warrant medical evaluation. neither explains most cases.to 4-year-old children is more than nine times greater than the rate for young adults ages 20 to 24. Possible Causes of Leukemia Anyone can get leukemia. Children. The incidence rate for all cancers among AfricanAmericans in the Seer (17 region). LEUKEMIA LYMPHOMA MYELOMA page 7 . from 2000-2004.5 times that of ALL.Estimated Proportion of New Cases (%) in 2007 for Each Type of Leukemia Including Adults and Children 3. Although chronic exposure to benzene in the workplace and exposure to extraordinary doses of irradiation can be causes of the disease. The leukemias represented 27 percent of all cancers occurring among children younger than 20 years from 2000-2004. Some people with chronic leukemia may not have major symptoms and are diagnosed during a medical examination. American Cancer Society. About 2. averaging about 189. Signs and Symptoms of Leukemia Signs of acute leukemia may include • Easy bruising or bleeding (because of platelet deficiency) • Paleness or easy fatigue (because of anemia) • Recurrent minor infections or poor healing of minor cuts (because of inadequate white cell count). Leukemia strikes all ages and both sexes. Adults.900 new cases of cancer diagnosed in African-Americans in 2007. Hispanic children of all races under the age of 20 have the highest rates of leukemia. including the examination of the cells in blood or marrow. These signs are not specific to leukemia and may be caused by other disorders.to 19-year olds. was 504 per 100.790 new cases of childhood ALL are expected to occur in 2007. In 25. the incidence of AML slowly rose while that of ALL steadily decreased in the period from late adolescence to older adulthood.922 cases per year. ALL incidence was approximately twice that of AML. Leukemia incidence is highest among whites and lowest among American Indians/Alaskan natives. AML incidence was approximately 1. Leukemia is one of the top 15 most frequently occurring cancers in minority groups.to 29-year olds. CLL incidence increases dramatically among people who are aged 50 and older. From 1975 to 2000. The cause of leukemia is not known. there were 4. white and Asian/Pacific islander children than for black children. It is estimated that in 2007. Most children under 15 years of age with ALL are cured. 2007. The most common form of leukemia among children under 20 years of age is ALL.619 with ALL. Adolescents and Young Adults. However. The incidence of ALL among 1. In the 17 SEER regions of the United States. leukemia rates are higher in Americans of European descent than among those of African descent.799 children under the age of 20 diagnosed with leukemia from 2001-2004. including 3. 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. eighth and ninth decades of life. CML incidence also increases dramatically among people who are aged 60 and older. These cancers are most prevalent in the seventh. Incidence by Age-Group Incidence rates by age differ for each of the leukemias. The American Cancer Society estimates that there will be approximately 152. Incidence by Race and Ethnicity Incidence rates for all types of cancer combined are more than 5 percent higher among Americans of African descent than among those of European descent. Among 15. and AML incidence increases dramatically in people who are aged 60 and older.800 children will be diagnosed with leukemia throughout the United States. Figure 3: Source: Cancer Facts & Figures 2007. American Indian/Alaskan natives. The diagnosis of leukemia requires specific blood tests. Leukemia rates are substantially higher for Hispanic.
LEUKEMIA page 8 LYMPHOMA MYELOMA . gender.4 percent Five-Year Relative Survival Rates for All Ages. 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. Relapse indicates return of the cancer cells and the return of other signs and symptoms of the disease.6 10-14 0.3 3. Thirty-two percent more males than females are living with leukemia.4 5-9 0.2 23 21 19 19. The relative survival rates differ by age of the patient at diagnosis.3 1. a complete remission (no evidence of disease in the blood or marrow) that lasts five years after treatment often indicates cure.9 25-29 1. Treatment of Leukemia The aim of treatment is to bring about a complete remission. 54.1 for children under 15 • CML: 44. the five-year relative survival rates overall were: • ALL: 65.3 percent overall.6 2. when compared to a person without leukemia.5 21. All Types Leukemia.2 10. 2007.2 1. 2007. race and type of leukemia.4 <1 0. During 1996-2003. By 1975-1977.8 1-4 0.1 Incidence (per 100. 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.9 20-24 0. the overall relative survival rate was nearly 50 percent.4 percent for children under 5 • CLL: 74.7 7 5 3 1 0 1.Age-Specific Incidence Rates for Acute Myelogenous Leukemia (All Races). 90.8 percent • AML: 20. Treatment centers report increasing numbers of patients with leukemia who are in complete remission at least five years after diagnosis of their disease. For acute leukemia. National Cancer Institute.7 percent overall. Complete remission means that there is no evidence of the disease and the patient returns to good health with normal blood and marrow cells.2 15 13 11 9 7. Epidemiology and End Results) Cancer Statistics Review 1975-2004. In 1960-1963. National Cancer Institute. Epidemiology and End Results) Cancer Statistics Review 1975-2004.1 4. 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. the five-year relative survival rate had jumped to 35 percent.000) 17 15. 2000-2004 25 23.9 15-19 0. The five-year relative survival rate has more than tripled in the past 47 years for patients with leukemia.
990 deaths from AML and 490 deaths from CML. There will be an estimated 4.390 additional deaths. Hispanics with leukemia who are under the age of 25 had the highest mortality rates from the disease between 1990 and 1999. National Cancer Institute.470 Table 4: Source: Cancer Facts & Figures 2007. 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.320 Female 600 1. Non-Hispanic whites diagnosed with leukemia over the age of 44 had the highest death rates during this period. 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 21.500 8. 2007.500 deaths from CLL and 1. In 2007.710 9. 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. leukemia causes more deaths than any other cancer among children and young adults under age 20.420 4.420 deaths from ALL. Zuelzer WW. in Children Under 15 Years of Age. American Cancer Society.560 5. Epidemiology and End Results). leukemia will be the fifth most common cause of cancer deaths in men and the sixth most common in women. Unclassified forms of leukemia will account for 6. SEER (Surveillance.990 490 6. deaths from leukemia are expected to be distributed in the following numbers: In 2007. Survival Rates 50% 40% 30% 20% 10% 0% 19641 197519772 197819802 198119832 198419862 198719892 199019922 199319952 199620032 3% Years Figure 6: The graph shows childhood ALL five-year relative survival rates have improved significantly over the past nearly 40 years. 1964:24:477-494.940 3. about 515 children under the age of 14 are expected to die from leukemia. Cancer Statistics Review. Implications of long-term survivals in acute stem cell leukemia of childhood treated with composite cyclic therapy.Five-Year Relative Survival Rates for Acute Lymphocytic Leukemia. Blood. Despite this decline.470 females. Deaths It is anticipated that approximately 21.320 males and 9. In 2007.020 240 3. There will be an estimated 8. LEUKEMIA LYMPHOMA MYELOMA page 9 . unclassified forms of leukemia Total Overall 1. 1975-2004.680 12. 2007.790 deaths in the United States will be attributed to leukemia in 2007: 12. Sources: 1.970 250 2. 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.790 Male 820 2.
incidence rates for non.5 percent of all lymphomas diagnosed in 2007. Both Hodgkin and non-Hodgkin lymphomas are more common in males than in females. Hodgkin lymphoma has characteristics that distinguish it from all other cancers of the lymphatic system.000 at ages 20 to 24 for males and 1.6 per 100.190 cases of non-Hodgkin lymphoma). More than four percent of all cases of Hodgkin lymphoma diagnosed in 2007 will be in children under 15 years of age. Age-specific incidence rates of non-Hodgkin lymphoma are 2. American Cancer Society.470 34. rose by 84 percent from 1975 to 2004. The bacterium Helicobacter pylori is associated with the development of lymphoma in the stomach wall. Non-Hodgkin lymphoma is the fifth most common cancer in males and females in the United States.190 71.380 Americans will be diagnosed with lymphoma in 2007 (8. The groups are often classified as indolent or aggressive.200 38.Hodgkin lymphoma are higher in Americans of European descent than among those of African descent. Each histologic grouping is diagnosed and treated differently. The reasons for the development of non-Hodgkin lymphoma are not certain. while 0.000 for females. population who are living with lymphoma. Immune suppression plays a role in some patients. in general whites have higher incidence rates than blacks.266 members of the U.380 Table 5: Source: Cancer Facts & Figures 2007. Fifty-three percent of the blood cancers diagnosed are lymphomas. New Cases About 71.9 per 100. 2007. 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.313 people living with Hodgkin lymphoma (active disease or in remission) and 405. New Cases of Lymphoma by Gender.8 percent. there are 138. an average annual percentage increase of 2.3 per 100.953 people living with nonHodgkin lymphoma for a total of 544. LEUKEMIA page 10 LYMPHOMA MYELOMA .S. It is the sixth most common cause of cancer deaths in males and in females.000 for males and 38.990 32. they are 52. The incidence of Hodgkin lymphoma is consistently lower than that of non-Hodgkin lymphoma. Hodgkin Lymphoma Hodgkin lymphoma is a specialized form of lymphoma and will represent about 11.720 28. Incidence by Gender Table 5 illustrates the breakdown of incidence of lymphoma by gender. Incidence rates for Hodgkin lymphoma tend to be higher among males than among females.710 Total 8.Lymphoma Lymphoma is a general term for a group of cancers that originates in the lymphatic system. Lymphoma results when a lymphocyte (a type of white blood cell) undergoes a malignant change and begins to multiply. Living with Lymphoma In the United States in 2007. or low.7 percent of all cases of non-Hodgkin lymphoma will be diagnosed in children under 15 years of age this year.190 63. By ages 60 to 64. Persons infected with the human immunodeficiency virus (HIV) have a much higher risk of developing lymphoma.9 per 100. The Epstein-Barr virus causes Burkitt’s lymphoma in Africa. 2007 Type Hodgkin lymphoma Non-Hodgkin lymphoma Total Male 4. intermediate and high grade. The age-adjusted incidence of non-Hodgkin lymphoma Incidence by Race and Ethnicity Although blacks in their mid 20s to late 40s have higher incidence rates of non-Hodgkin lymphoma than whites. the difference was small.670 Female 3.000 for females. eventually crowding out healthy cells and creating tumors that enlarge the lymph nodes or other sites in the body. malignant cell found in Hodgkin lymphoma tissues). After 50 to 54 years of age. These risk factors explain only a small proportion of cases. and each has prognostic factors that categorize it as more or less favorable.190 cases of Hodgkin lymphoma and 63. including the presence of an abnormal cell called the ReedSternberg cell (a large. In 2004.
Adolescents are more commonly diagnosed with Hodgkin lymphoma than young children.1 cases per 100. Early stage. troublesome itching and weight loss. Survival for Children Five-year relative survival is 95. loss of appetite and bone pain. lymphomas are most commonly diagnosed in whites (24.8 percent for all races in 1996-2003. Treatment Hodgkin lymphoma is often treated with radiation and chemotherapy. Incidence in Adults The incidence of non-Hodgkin lymphoma increases with age. cell type and location of the lymphoma.000 people occur in 20. Lymphomas (Hodgkin lymphoma. groin or in the abdomen. Deaths An estimated 19. and non-Hodgkin lymphoma. Incidence in Children The incidence of Hodgkin lymphoma among people under 20 years of age was 1. The five-year relative survival rate for non-Hodgkin lymphoma patients has risen from 31 percent in whites in 1960-1963 to 63. chemotherapy or both may result in cures for most patients with Hodgkin lymphoma.000 persons at ages 80 to 84. the highest incidence of non-Hodgkin lymphoma is in non-Hispanic whites.1 per 100. comprising nearly 5 percent of all cancers diagnosed. and more than 46-fold to 112. Signs and Symptoms Signs and symptoms of Hodgkin lymphoma include painless swelling of lymph nodes in the neck.400 children under the age of 15 will be diagnosed with cancer in 2007.4 cases per 100.5 percent) are the third most common cancers in children. Five-year relative survival is now 95 percent for Hodgkin lymphoma in children aged 0 to 14 years. 3. LEUKEMIA LYMPHOMA MYELOMA page 11 . It has remained fairly constant since 1999. From ages 15 to 19. Treatment for non-Hodgkin lymphoma sometimes includes vaccines and other forms of immunotherapy. followed closely by Hispanic children of all races (24. The rate increases more than 18 times to 45. In children under 20 years of age. armpit.0/1 million population). Non-Hodgkin lymphoma is the ninth most common cause of cancer death in males and the seventh in females in the United States.000 by ages 60 to 64. excessive tiredness.5/1 million population). indigestion and abdominal pain. localized non-Hodgkin lymphoma is sometimes treated with radiation.1 cases per 100. five-year relative survival for non-Hodgkin lymphoma is now 83. recurrent high fever. following leukemia (26. Hodgkin lymphoma incidence rates are higher in adolescents and young adults than in adults in their middle years.to 24year-old individuals. Symptoms also often include fever. Death rates have been declining for Hodgkin lymphoma patients since the mid-1970s. armpit or groin. In the United States. about 10. the highest incidence of non-Hodgkin lymphoma is in Asian/Pacific islanders. The most common early sign of other forms of lymphoma is also painless swelling of the lymph nodes – usually in the neck. In children up to age 14 years. Hispanics of all races have the second highest incidence rates of non-Hodgkin lymphoma after whites.660 from 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. 1. widespread disease requires chemotherapy or chemotherapy and/or monoclonal antibody therapy with radiation.730 persons will die from lymphoma in the United States in 2007 (18.000 children in 2004. and is the eighth most common cause of cancer death in that group. 4.2 percent for Hodgkin lymphoma in people under 20 years of age. sweating at night. This represents a significant improvement in the rate of recovery.Among women. Non-Hodgkin lymphoma is the fifth most common cancer in Hispanics.5 percent. most children with nonHodgkin lymphoma did not live five years after diagnosis.5 percent. It is rarest among American Indian/ Alaskan native children. Even in the mid-1970s. The incidence in this group decreased almost steadily and significantly between 1975 and 1999. persistent fatigue. night sweats. In children from 0 to 19 years of age. Radiation.070 from Hodgkin lymphoma).8 percent) and neoplasms of the brain and other nervous tissue (17. depending on the tumor size. Survival for Adults Hodgkin lymphoma is now considered to be one of the most curable forms of cancer.9 percent). About 2.
2 1.0 2.8 112.1 102. 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 2.0 20 10 0 0.1 63. 2007.660 19.0 0.370 Female 300 9. American Cancer Society.4 3.600 10. Age-Specific Incidence Rates for Non-Hodgkin Lymphoma. Epidemiology and End Results) Cancer Statistics Review 1975-2004. Epidemiology and End Results) Cancer Statistics Review 1975-2004.730 Male 770 9.0 100. Epidemiology and End Results) Cancer Statistics Review 1975-2004.8 3.4 15. 2007.4 2.8 2.5 10. * <16 cases for time interval.6 0. Table 6: Source: SEER (Surveillance.000) 70 60 50 40 30 22.000) 5 4 3 2 1 0 0.Age-Specific Incidence Rates for Hodgkin Lymphoma.4 2.1 0.5 <1* 1-4 5-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 Age in Years 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85+ Figure 8: Sources: SEER (Surveillance.8 4.3 <1* 1-4 5-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85+ Age in Years Figure 7: Sources: SEER (Surveillance.4 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. National Cancer Institute.2 4.4 80. LEUKEMIA page 12 LYMPHOMA MYELOMA .9 7.070 18.1 3.9 4.4 4.9 1. 2007. 2000-2004 110 100 90 80 Incidence (per 100. *<16 cases per time interval. National Cancer Institute.9 3.060 9.6 32.1 0.0 45.1 4.1 3. 2000-2004 6 Incidence (per 100. National Cancer Institute.0 1.3 4. 2007.0 3.
a type of white blood cell found in many tissues of the body.3/100. two or three drugs are used simultaneously. 5-9.5/100. Treatment Chemotherapy for myeloma has led to sustained remissions in some patients.000). but it is the most difficult blood cancer to treat successfully. 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. 2007. median age at death from multiple myeloma is 74. 2000-2004 Incidence (per 100. 1-4.1/100. The onset of myeloma interferes with normal production of antibodies and makes myeloma patients susceptible to infections. Living with Myeloma An estimated 60.2/100. Survival Current statistical databases show that overall five-year relative survival in patients with myeloma has shown a significant improvement since the 1960s: 12 percent in 1960-1963 for whites to 34 percent from 1996-2003 for all races. Approximately 3 percent of all cancer-related deaths among AfricanAmericans in 2000-2004 were from myeloma. Fractures may occur as a result of the weakened bones.8 14. National Cancer Institute. Recurrent infections may be an early sign of the disease. New Cases An estimated 19.1 Signs and Symptoms Often the first symptom of myeloma is bone pain caused by the effects of myeloma cells in the marrow.S. SEER 17 areas (<1. becomes malignant. myeloma was the 10th most commonly diagnosed cancer among African-American men and women. It grows continuously and forms masses of plasma cells. causing pain and crowding out normal blood cell production.7 1. At times.424 people in the United States are living with myeloma.000) for all racial and ethnic groups. It is 71 for African-Americans.5/100. 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. especially in the marrow. (11.960 men and 8. • The median age at diagnosis is 70. Figure 9: Source: SEER (Surveillance. Patients may have anemia. has been increasing. tire more easily and feel weak. The highest rates are found in black men 80 to 84 years of age and older (105/100. and it rarely occurs in people under age 45. a B lymphocyte.1 28. From 2000 to 2004. Total survival for white males.000) of myeloma than those of European descent (5.900 (10. Lenalidomide is approved by the FDA in combination with dexamethasone for the treatment of myeloma patients who have received at least one prior therapy. 10-14. destroying normal bone tissue.000).000) 40 30 20 10 0 0-24 0. Treatment may include intensive chemotherapy followed by stem cell transplantation to restore normal blood cell production. approximately double.1 5. Sixty percent of those were diagnosed with the disease within the past four years.0 37. 20-24). Treatment is aimed at slowing progress of the disease. Epidemiology and End Results) Cancer Statistics Review 1975-2004.5 3.4 35.1 0.000).940 women) new cases of myeloma will be diagnosed in the United States in 2007.9 9. Thalidomide is approved by the FDA for use in treating newly diagnosed myeloma. • The incidence rate in men (7/100. Myeloma was the 10th most common cause of cancer deaths for women in 2000-2004.1 21. • Americans of African descent have a much higher incidence rate.Myeloma Myeloma is a cancer of the plasma cells.4 33. 15-19. the patient’s own stem cells are used (autologous stem cell infusion). The mortality rate from myeloma for people of African descent is more than double the rate for whites (7. Malignant plasma cells produce an abnormal protein called monoclonal immunoglobulin. the cell that forms plasma cells. The U.000 to 3. *<16 cases for each age interval. Age-Specific Incidence Rates for Myeloma.3 0. but primarily in the bone marrow. Usually.790 deaths from myeloma are anticipated this year. Bortezomib has been approved for treating myeloma in patients who have had at least two prior therapies. In myeloma.000) is 56 percent higher than for women (4. LEUKEMIA LYMPHOMA MYELOMA page 13 . especially. • The median age at diagnosis for African-Americans is 67. Deaths Approximately 10.
3 Male 13. (Based on SEER 17 areas.0 7.000 Population (2000-2004) Type Leukemia Non-Hodgkin lymphoma Hodgkin lymphoma Myeloma Overall 10. the most recent available.9 5. Hodgkin and non-Hodgkin lymphoma and myeloma use figures from 2000-2004. Epidemiology and End Results) Cancer Statistics Review 1975-2004.2 14.0 Female 9.5 16.) LEUKEMIA page 14 LYMPHOMA MYELOMA .1 2.9 17.) Table 9: Source: SEER (Surveillance. for Whites.) Incidence Rates by Gender.3 19.6 2. 2007.1 3.2 2.3 2.3 2. (Based on SEER 17 areas.6 Male 16.1 11.000 population and are age-adjusted to the 2000 population.2 18.7 24. Lymphoma and Myeloma The following tables showing incidence rates for leukemia.Incidence Rates: Leukemia. Epidemiology and End Results) Cancer Statistics Review 1975-2004.000 Population (2000-2004) Type Leukemia Non-Hodgkin lymphoma Hodgkin lymphoma Myeloma Overall 12.0 Female 8.8 20. per 100.5 Table 8: Source: SEER (Surveillance.5 Incidence Rates by Gender.9 2. National Cancer Institute.1 9.0 2. All Races. Epidemiology and End Results) Cancer Statistics Review 1975-2004.6 Female 9. for Blacks. (Based on SEER 17 areas.2 6.4 11.2 Male 16. 2007. 2007.6 4. National Cancer Institute.2 3.7 5. per 100.4 4. Incidence Rates by Gender.8 14. Rates are per 100. National Cancer Institute.000 Population (2000-2004) Type Leukemia Non-Hodgkin lymphoma Hodgkin lymphoma Myeloma Overall 12. per 100.1 Table 10: Source: SEER (Surveillance.0 23.
040 70 44. January/February 2007. ***Hodgkin lymphoma estimates are not available for 2007. **State estimates may not add up to U.Estimated New Cases of Blood Cancers by Site.540 1.160 1.530 1. National Center for Health Statistics.680 920 340 890 170 290 330 190 1. Used with permission. by State. 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 4.370 100 * 430 380 130 350 * 19.030 910 620 420 680 680 250 630 1.670 1.560 770 890 3. by State.070 80 330 70 480 1.300 110 63. Mortality Public Use Data Tapes.240 740 80 1. and additional data supplied by the American Cancer Society.500 430 1.630 540 80 120 990 510 310 230 320 330 100 390 490 770 400 210 460 80 150 160 100 680 120 1. total because of rounding and exclusion of estimates that are fewer than 50 cases. 2007 State Leukemia Non-Hodgkin Lymphoma Myeloma Hodgkin Lymphoma*** Estimated Deaths from Blood Cancers by Site. *Estimate is fewer than 50 cases.070 110 1. Table 12: Sources: Cancer Facts & Figures 2007.830 240 230 60 * 1. which is new for 2007.S. American Cancer Society.170 480 1. is described by Pickle et al.300 470 90 100 750 430 300 220 290 310 110 320 420 660 350 170 500 80 110 130 90 600 120 1.250 1.360 610 * 950 290 260 1.550 2. numbers are small and NCI and ACS are having difficulty fitting them into the Pickle et al.070 Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Dist. Note: These estimates are offered as a rough guide and should be interpreted with caution.360 960 170 220 2.610 150 2.080 1.140 380 140 1.520 310 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** 350 * 400 240 2.080 600 7.S. **State estimates may not add up to U. total because of rounding and exclusion of estimates that are fewer than 50 cases.550 * * * * *20 * * * * 60 * * * 50 * * * * * * * * * * * * * * * * * * 70 * * 50 * * 60 * * * * 80 * * * * * * * 390 Table 11: Sources: Cancer Facts & Figures 2007.S.790 330 * 320 200 1.370 250 280 2..660 210 * 190 120 1. 2006. and additional data supplied by the American Cancer Society based on data from the U. CA A Cancer Journal for Clinicians.390 1. *Estimate is fewer than 50 cases. Used with permission.880 240 250 50 50 1.330 260 780 180 1.710 570 500 2.240 170 550 130 800 3.030 570 * 610 210 360 1. 2007 State Leukemia Non-Hodgkin Lymphoma Myeloma Hodgkin Lymphoma Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Dist.130 300 80 900 960 300 1. Numbers are rounded to the nearest 10.150 290 270 70 * 1.190 290 * 280 200 1. 2007.610 670 610 110 60 3. Numbers are rounded to the nearest 10.410 560 * 740 230 230 930 70 300 50 350 1.160 140 50 360 440 170 320 * 18.190 880 870 170 100 4.310 800 600 900 920 330 1.010 1. 1969-2004.200 350 4.180 4. Centers for Disease Control and Prevention. Note: These estimates are offered as a rough guide and should be interpreted with caution. American Cancer Society. They cannot be compared with previous years’ estimates to determine cancer incidence trends. LEUKEMIA LYMPHOMA MYELOMA page 15 .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 * 10.510 500 60 70 900 380 220 160 280 430 100 370 460 730 310 170 400 70 110 120 80 650 120 1.260 220 400 420 290 2.410 130 50 500 490 130 490 * 21. model (see below).140 60 260 80 410 1. 2007. The method of derivation.
2007. 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. population.” as per SEER table I-21.) Prevalence is the estimated number of people alive on a certain date in a population who previously had a diagnosis of the disease. The relative survival rate is a comparison of survival to a person who is free of the disease. It considers deaths from all causes. Thus. his or her survival with leukemia may not be counted in leukemia prevalence statistics. (Observed survival is the actual percentage of patients still alive at some specified time after diagnosis of cancer. This change means that the 2007 incidence estimates are not comparable with previous estimates for determining cancer incidence trends. In some prevalence statistics. population) that belong to the National Program of Cancer Registries. The SEER (17 region) data cover only about 26 percent of the U. Census. Definitions Incidence is the number of newly diagnosed cases for a specific cancer or for all cancers combined during a specific time period. 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. Thus. 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. Because of changes in the information — such as racial classification — gathered in the 2000 U. In this report. cancer or otherwise. based on the “first invasive tumor for each cancer site diagnosed during the previous 29 years (1975-2003). CA A Cancer Journal for Clinicians. so the exact number of cases is not known. This year. LEUKEMIA page 16 LYMPHOMA MYELOMA . The description of the methods used was published in Pickle et al. The data can be extrapolated for the entire United States by multiplying by the population ratio. January/February 2007. state-by-state data for incidence of Hodgkin lymphoma are not available because these numbers are so small. only the first diagnosed cancer counts. Because of reporting delays from some of the SEER regions. Epidemiology and End Results Program (SEER) regions (or. The specified date is 1/1/2004 for the prevalence estimates. race or sex. survival and mortality have been revised. may be incomplete in some cases and the data may reflect adjustments that anticipate changes that will occur once the actual data are received. Incidence rates can be calculated based on a number of factors such as age. especially in looking at populations in which individuals have had more than one type of cancer.S. if a person is initially diagnosed with melanoma and later develops leukemia. 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. mostly upward.. Age-adjusted rate is an incidence or mortality rate that has been adjusted to reduce the effects of differences in the age distributions of the populations being compared. in comparison to the 2002 SEER report. in some cases fewer than 17 SEER regions) and death data from the National Center for Health Statistics. 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.” We are using the “29-year limited duration” prevalence figures. the data presented in the 2007 SEER report placed online on April 15. no matter how long ago that diagnosis was.S. Bureau of the Census’ 2000 population data for that region. the American Cancer Society changed its method of estimating cancer incidence.S. The data presented in this report are an extrapolation or estimate of the number of cases reported by the 17 Surveillance. Prevalence may be calculated in a number of different ways. race and ethnicity in various regions and region-specific health risks. it is the number of new cases per standard unit of population during the time period.Notes and Definitions Notes The United States does not have a nationwide reporting system or registry for blood cancers. estimates of cancer incidence. 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. It includes new (incidence) and preexisting cases and is a function of both past incidence and survival. Relative survival rate is an estimate of the percentage of patients who would be expected to survive the effects of the cancer. Because of this change in method.S.
Bethesda. Epidemiology. Edwards BK. Reichman M. Zou Z. http://seer. and Multiple Primary Cancer Analyses from the Surveillance.amcancersoc. National Cancer Institute.gov/csr/1975_2004/ LEUKEMIA LYMPHOMA MYELOMA page 17 . 2006. NIH Pub. Barr R. In Cancer Epidemiology in Older Adolescents and Young Adults 15 to 29 Years of Age. and End Results (SEER) Program.” O’Leary M. Including SEER Incidence and Survival: 1975-2000. No. Ries LAG (eds). pp. January/February. Including SEER Incidence and Survival: 1975-2000. Melbert D. “Highlights and Challenges. No. and End Results) Cancer Statistics Review. Ward E. Ries LAG (eds). Bleyer A. 065767. National Cancer Institute. Bethesda.cancer. pp. “A New Method of Estimating United States and State-Level Cancer Incidence Counts for the Current Calendar Year. Cancer Facts & Figures for African Americans 2007-2008.” Bleyer A.org/cgi/content/full/57/1/30. Bethesda. Stock W. Reichman ME. Barr R. 2007. Hachey M. 25-38. http://www. Shu X-O. 2006. Feuer EJ. Bleyer A. Hao Y. “Leukemias. Ross J. 12. pp. January. pp. Bethesda. In Cancer Epidemiology in Older Adolescents and Young Adults 15 to 29 Years of Age. NIH Pub. Ries LAG (eds). Horner MJ.” Pickle LW. MD. MD. O’Leary M. NIH Pub. No. Ries LAG. “Lymphomas and Reticuloendothelial Neoplasms. MD. Atlanta: American Cancer Society. posted to the SEER Web site 2007. O’Leary M. 2007. Howlader N. Barr R. “Cancer Statistics. SEER (Surveillance. 20-37.Citations Source Citations Cancer Facts & Figures 2007. p.” Mattano L Jr. Sheaffer J. 2006. Howlander N. National Cancer Institute. O’Leary M. Edwards BK (eds). MD. 39-51. Bleyer A. Barr R. 06-5767. 174. 1975-2004. Howe HL. The Oncologist Vol. Cheson B. Krapcho M. Tiwari RC. Epidemiology. CA A Cancer Journal for Clinicians Vol. Jemal A. Trends. Mariotto A.” Hayat MJ. Including SEER Incidence and Survival: 1975-2000. Keller F. 065767. Miller BA. In Cancer Epidemiology in Older Adolescents and Young Adults 15 to 29 Years of Age. 57. Clegg L.com/cgi/content/full/12/1/20. 30-42. Feuer EJ.TheOncologist. Nachman J. 2007. Atlanta: American Cancer Society. based on November 2006 SEER data submission. Eisner MP. National Cancer Institute. http://caonline. 2007.
Thus. Funding for two additional years may be provided for highly promising projects that are entering phase I clinical trial. The program is expected to generate new knowledge and breakthrough discoveries. diagnosis or prevention in the near term.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. Now supporting $61.000 a year for a total of $550.000 a year for a total of $180. lymphoma and myeloma. Research Research Grant Programs The Society’s research programs are based on the belief that all scientifically sound approaches toward a cure for. Research grants are awarded in three program areas: Career Development. lymphoma and myeloma research comprise four review subcomittees. lymphoma. lymphoma and myeloma that is intended to advance treatment.000 a year for a total of $150. The SCOR grants also support scientific core laboratories to provide access to innovative technology if required by the participating research programs. Each SCOR is funded up to $1.000 a year for a total of $180. Awards go to those groups that best demonstrate the synergy that will occur from their close interaction. The Society is a nonprofit organization that relies on the generosity of individual and corporate contributions to advance its mission. • Special Fellows are awarded $60. 3) Translational Research Program. the Society’s grant programs are among the most prestigious in the fields of blood cancers. leukemia.000 over three years. Lymphoma and Myeloma These center grants are awarded to a cluster of at least three research groups that interact to foster advances in the diagnosis.25 million per year over a five-year period.000 over five years.000 over three years. leading to better survival rates and prevention measures for patients.000 over five years. The SCOR program brings together research teams working in complementary areas. Awards up to $200.6 million annually on research.000 per year for three years. Translational Research Program The Translational Research Program provides early-stage support for research on leukemia. and improve the quality of life of patients and their families. Translational Research and the Specialized Center of Research (SCOR). 2) CDP-clinical research. treatment or prevention of leukemia.000 over three years. are granted each year. Career Development Program The Career Development Program supports promising young scientists (Scholars. • Fellows are awarded $50. lymphoma or myeloma. The Grant Review Process Scientists and physician-scientists who are experts in the field of leukemia. Hodgkin’s disease and myeloma. Translational Research • Scholars in Clinical Research are awarded $110. Translational Research Awards are made for an initial three-year period. They are: 1) Career Development Program (CDP)-basic research. The Specialized Center of Research (SCOR) in Leukemia. each focused on the discovery of new approaches to benefit patients or those at risk for developing leukemia.000 a year for a total of $550. to a total cost of $6. • Special Fellows in Clinical Research are awarded $60. or control of. The participating scientists may be at different institutions or from any country. for a total of $600. 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 . the Society has awarded more than $550 million in research grants.000. Special Fellows and Fellows) pursuing careers and is stratified into two separately reviewed programs in basic or clinical research: Basic Research • Scholars are awarded $110. lymphoma and myeloma should be encouraged worldwide.25 million. research reaching a clinical trial can receive $1 million over five years to facilitate new drug discovery or advances in diagnosis or prevention. Since the first funding in 1954. We offer a wide variety of programs and services in support of our mission: Cure leukemia.
org. Teleconferences and Webcasts The Society sponsors more than 25 educational teleconferences and Webcasts each year on topics of interest to patients and caregivers. families.m. The Society funds several Focused Workshops each year on important topics relevant to hematological malignancies. Patients.m. podcasts and Webcast archives of these programs are available at www.org or by or emailing researchprograms@LLS. on the Society’s Web site. each group provides information and support. information about our peer-to-peer program First Connection and other programs. The Annual Research Symposium. including support groups. www. Family Support Group locations. peer counseling and patient financial aid.org/copay. and applications for the Society’s three research programs may be obtained by visiting www. lymphoma. their families and healthcare professionals. This support should advance the understanding. These include the Stohlman Scholar Symposium.m. families and professionals may call the IRC toll free at (800) 955-4572 in addition to corresponding by email at infocenter@LLS. First Connection: This program links newly diagnosed patients to a peer volunteer who has experienced a similar diagnosis. Monday through Friday. You may also chat online with an information specialist.” Chapter Programs: Family Support Groups: The Society has developed more than 360 Family Support Groups at 68 chapters. from 10:00 a. brochures and videos through the IRC and local Society chapters.m. The user has the opportunity to create personalized pages with identified interests. 9 a. 2007 the Society will have 379 active grantees at 116 institutions in the United States and abroad. Patients needing assistance may apply on the Society’s Web site. treatments. Patient Services The Society has a network of 68 chapters throughout the United States and Canada. clinical trials and offer guidance on coping. The educational program offers varying formats to facilitate the exchange of information and ideas on the newest developments in cancer research and treatment. These offices conduct lifeenhancing patient services.LLS.LLS. Other meetings are held for the Society’s grantees.org. Professional Education The Society serves the continuing educational needs of the medical and research community through professional symposia offered throughout the year. Guided by two volunteer oncology health professionals. call (877) LLS-COPAY ( 557-2672) or email copay@LLS. lymphoma and myeloma. treatment and prevention of leukemia. Educational Materials An extensive collection of free educational materials are offered to patients and health professionals. Information specialists are oncology social workers and health educators who provide callers with current information on blood cancers. the Society’s programs and services.LLS. audio. 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. the Society distributes more than 1 million booklets. The site features a comprehensive overview of blood cancers. It is continually being updated and expanded to support and promote the Society’s mission.org. sponsored by the Society. A trained patient volunteer currently in remission phones the new patient to share information and support. LEUKEMIA LYMPHOMA MYELOMA page 19 .org.org.LLS. the Translational Research Grant Progress Review Meeting and the SCOR Progress Review Meeting. Each year.important projects to advance the Society’s mission. ET. The Society’s Web Site The Society’s Web site. and encourages greater communication among patients. serves a wide variety of education and information needs. www. and click “Live Help. ET. The Society also hosts numerous teleconferences and Webcasts. to 5:00 p.org.LLS. www. Information Resource Center (IRC) The Society strives to be the world’s foremost source of information on leukemia. lymphoma. to 6 p. Guidelines. myelodysplastic syndromes (MDS) and other blood cancers. Information on registration for these free events can be accessed at www. instructions. myeloma. is held each December on the Friday immediately before the American Society of Hematology meeting. friends and healthcare professionals.org.LLS. Co-Pay Assistance Program Patients with AML. They are available to talk one-onone. where medical professionals share the latest research findings. As of June 30. Much of the content of these materials is available to view and download at www. The IRC is a worldwide link to information and resources useful to patients.org or faxing to (914) 949-6691 or contacting the Research Department at (914) 949-5213.LLS.
Society volunteers and staff visit Capitol Hill regularly to lobby Congress in support of issues that impact research and patient care.org and is being sponsored by a generous. The Path to Progress: Clinical Trials in Blood Cancers: This program provides patients. families and healthcare professionals with a clear description of what clinical trials are.Patient Financial Aid Program: For more than 31 years. treatments. videos and other materials to aid the process are available through all local chapters. and offers numerous resources that can assist childhood cancer survivors to flourish in the school environment posttreatment. That network now numbers more than 35. patients and school personnel to assure youngsters a smooth transition from active treatment back to school. Advocacy Since 1994. New insights. including • Insurance coverage of patient-care costs in clinical trials • Ready access by all Americans to quality cancer care • Increased funding for the National Institutes of Health and National Cancer Institute (NCI) • Increased funding for blood cancer research at other federal institutions • Federal funding for patient education and support programs. Through the Patient Financial Aid Program. Printed literature. that program has funded some $30 million in additional blood cancer research. CML Issues and Insights: A Nursing Education Program on Chronic Myelogenous Leukemia. 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. the Society has helped patients demonstrating a need for financial assistance cover a portion of their treatment costs. 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. The patient education program was funded at $18 million through 2007. Working through chapters across the country. how cancer drugs are developed and what the emerging treatment options are for leukemia. This program is made possible by the Lance Armstrong Foundation. parents. emerging therapies and side effects and addresses the unique challenges of nursing management of these patients. reimbursement of up to $500 per year helps cover the costs of transportation. This nursing education program provides an overview of CML. On the state level. In 2002.and long-term effects that children may experience after treatment. drugs and various treatments not covered by insurance. It is supported by Amgen Oncology. the Society’s advocacy program has been a strong voice in Washington. In 2001. LEUKEMIA page 20 LYMPHOMA MYELOMA . This program is provided through an unrestricted educational grant from Millennium Pharmaceuticals. diagnosis. Department of Defense’s medical research program. Patient financial aid funds are subject to availability. This program is being sponsored by an unrestricted education grant from Novartis Oncology. unrestricted educational grant from Genentech BioOncology and Biogen Idec Inc. DC.000 and has become a potent voice in public policy deliberations. 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. Welcome Back: Facilitating the Return to School for Children with Cancer: A new addition to The Trish Greene Back to School Program. This program is also accessible as a Webcast at www. The Trish Greene Back to School Program for Children with Cancer: This program is designed to increase communication among healthcare professionals. treatments and future directions for NHL are also discussed. lymphoma and myeloma.LLS. emerging therapies and managing side effects and how to find emotional support when living with the illness.S. Meet the Expert on Non-Hodgkin Lymphoma: This program presents basic information on terminology. this education program discusses possible emotional and cognitive short. risk factors. treatments. The Society has identified key issues that currently shape its advocacy agenda. New Directions in Myeloma Therapy: This program presents an overview of myeloma. the Society has successfully ensured coverage of routine care in cancer clinical trials in three states and secured additional funding for patient support programs in four others. providing additional support for blood cancer patients and their families nationwide. staging and classification of nonHodgkin lymphoma (NHL). representing to policy makers at all levels of government the healthcare quality concerns and medical research interests of patients and their families. This Society program is being supported by Celgene Corporation and Millennium Pharmaceuticals. the Society successfully lobbied Congress to institute a blood cancer research initiative as part of the U. To date.
of the American Cancer Society (ACS). Milton Eisner of SEER.Acknowledgements Additional data from SEER*Stat Databases at http://www. NCI. for compilation of data for this publication.cancer.seer. provided statistical assistance.D. It is distributed as a public service by The Leukemia & Lymphoma Society Inc. Ph. provided ACS’s state-by-state statistics on myeloma and Hodgkin lymphoma. This publication is designed to provide information in regard to the subject matter covered. The Leukemia & Lymphoma Society extends special thanks to Myrna Watanabe.. . and Rebecca Siegel.gov. with the understanding that the Society is not engaged in rendering medical or other professional services.
corporate and foundation contributions to advance its mission.955. and improve the quality of life of patients and their families. New York 10605 Tel: 888.HELP. Suite 310 White Plains.LLS. lymphoma.Home Office 1311 Mamaroneck Avenue.4572 www. The Society is a nonprofit organization that relies on the generosity of individual.org Our mission: Cure leukemia. Hodgkin’s disease and myeloma.LLS Information Resource Center (IRC): 800. PS80 35M 6/07 .
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