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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.
4 percent of the 1. page 16). 2007 and SEER 19731993.266 people living today with lymphoma.730 people will die from lymphoma (1. • This year. which becomes malignant and multiplies continuously. Cancer Statistics Review 1975-2004 (see Notes. the National Cancer Institute’s Surveillance. This year.444.900 people will be diagnosed with myeloma. the incidence of myeloma increased 8 percent. 71. • Every five minutes. and its age-adjusted incidence rose by nearly 84 percent from 1975 to 2004. • Every 10 minutes. 19. Mortality from the disease increased 24 percent. 138. Five-Year Relative Survival Rates 1960-1963 vs.190 cases of non-Hodgkin). and myeloma.313 either have or are in remission from Hodgkin lymphoma. 405. nonacute myelogenous and monocytic leukemias Lymphoma: • There are 544. National Cancer Institute.1975-1977 vs. National Cancer Institute. 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. Deaths • Leukemia. 18.660 from non-Hodgkin). an annual publication.920 new cancer cases diagnosed in the United States this year. • Non-Hodgkin lymphoma is the fifth most common cancer in the United States.seer.070 from Hodgkin. 1960-1963 1975-1977 1996-2003 Figure 1: Sources: SEER (Surveillance.Executive Summary Facts 2007-2008. 10. These data were published online by SEER. From 1975 to 2004. www.520 people in the United States will be diagnosed with leukemia. Epidemiology and End Results) Cancer Statistics Review.190 cases of Hodgkin.380 new cases of lymphoma will be diagnosed in the United States (8.310 people in the United States this year.659 people in the United States who are either living with or are in remission from leukemia. 44. lymphoma and myeloma. • Thirty-two percent more males are living with leukemia than females. 2nd Edition. Myeloma: • • • • There are 60. This year.cancer. lymphoma and myeloma will cause the deaths of an estimated 52.gov. LEUKEMIA LYMPHOMA MYELOMA page 1 . Leukemia. Highlights from the Report Include: New Cases • An estimated 135. 1996. in April 2007. • New cases of leukemia.240 people will be diagnosed with leukemia. someone is diagnosed with a blood cancer. Epidemiology and End Results Program.3 percent of the deaths from cancer in 2007 based on the 559. Oxford University Press.953 either have or are in remission from non-Hodgkin lymphoma (NHL). 21. *Myeloma Biology and Management.790 people will die from myeloma. • This year.650 total cancer-related deaths. lymphoma and myeloma decreased from 1995 to 2004 (the last year data were available). is a compilation of the most recent data on leukemia. • In 2007. *except acute myelogenous leukemia (AML) and other. The data within Facts 2007-2008 reflect the most recent statistics available from SEER. 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. Survival • An estimated 823. 19. or nearly six people every hour. • These blood cancers will account for 9. • Eighty-six percent of myeloma cases occur in people aged 55 and over. This abnormal accumulation interferes with the production of healthy blood cells. More males are diagnosed with leukemia and more males die of it than females. 1975-2004. 1998. Hodgkin and non-Hodgkin lymphoma.790 people will die of leukemia. 63. • Leukemia causes more deaths than any other cancer among children and young adults under the age of 20. the likelihood of dying from most leukemias*.349 Americans are living with leukemia. • In 2007. The next SEER Cancer Statistics Review is expected to be published online in April 2008.424 people living today with myeloma. Hodgkin and non-Hodgkin lymphoma and myeloma will account for nearly 9. This statistic represents 143 people each day. someone dies from a blood cancer. • In general. lymphoma and myeloma in 2007.
2007. In special instances. However. Estimated New Cases (%) of Blood Cancers in 2007 Myeloma 15% Leukemia 33% Lymphoma 53% Treatment Chemotherapy and Radiotherapy: The use of chemotherapy (anticancer drugs). They are considered to be related cancers because they arise from cells with a common origin (the lymphohematopoietic stem cells) and with related functions. The harvesting. 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. 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 blood or marrow stem cells are collected while the patient is in remission. The technique of harvesting stem cells from blood and cord blood has made transplantation available for more LEUKEMIA page 2 LYMPHOMA MYELOMA . especially in young children. If a sibling is not available. slightly mismatched cord stem cell donors may be used quite successfully. The numbers of stem cells in cord blood are often insufficient for the needs Figure 2: Source: Cancer Facts & Figures.) of larger adult patients. lymphoma and myeloma. 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. American Cancer Society. 2007. freezing and storing of cord blood have provided another source of stem cells for transplantation. Syngeneic transplant describes the use of an identical twin as donor. Such an approach would greatly lessen the proportion of children without a donor. Patients with leukemia. 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. Patients with acute lymphocytic leukemia (ALL).About the Diseases Leukemia. An allogeneic transplant uses blood or marrow stem cells from a normal donor. 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. especially for children. studies suggest that two matched cord donors may result in a higher success rate in larger adults. 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. There are two major types of stem cell transplants: syngeneic and allogeneic. Stem cells also circulate in large numbers in fetal blood and can be recovered from umbilical cord and placental blood after childbirth. some types of Hodgkin lymphoma. usually in combinations of two or more drugs. Approximately 50 different drugs are now being used in the treatment of these diseases. These diseases usually result from an acquired genetic injury to the DNA of a single cell. The technique is important. is largely responsible for the dramatic improvement in managing leukemia and lymphoma. Hodgkin and non-Hodgkin lymphoma and myeloma are cancers that originate in a cell in the bone marrow or lymphatic tissues. Autologous transplantation uses the patient’s own marrow stem cells and is technically not transplantation since another person is not the donor. which becomes abnormal (malignant) and multiplies continuously. The accumulation of malignant cells interferes with the body’s production of normal blood or immune cells and can result in severe anemia. myeloma and lymphoma are usually treated with chemotherapy. usually a brother or sister with the same tissue type. for which a parent rather than a sibling could be the donor. Research is being conducted to improve socalled “haploidentical” transplant.
few severe adverse effects on normal tissues and a very high response rate. The protein is an enzyme in the family of tyrosine kinases. 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. Biomarkers could be high levels of certain substances in the body such as antibodies or hormones. Cancer survivors should have physical examinations yearly or more often. 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. these cells can be harvested from the blood of a donor. Over time.patients. 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. 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. Because blood. Coordination between specialists and primary care physicians is essential to provide the best care possible. It works by blocking the oncogeneencoded protein product that instigates the transformation to a leukemic cell. “Nonablative” allogeneic stem cell transplantation is the term applied to a technique of allogeneic transplant that uses lower doses of chemotherapy and/or radiotherapy to prepare the recipient for the donor’s stem cells. the recipient’s blood cell and immune system are preserved. lymphoma and myeloma. but some follow adult cancer survivors. as needed. decreased side effects. Stem cells not only reside in the marrow but also circulate in the blood. multi-disciplinary approach to monitoring and supporting cancer survivors. Some treatment centers have follow-up clinics that provide a comprehensive. Follow-Up Guidelines: The Children’s Oncology Group has established Long-Term Follow-Up Guidelines for Survivors of Childhood. frozen and stored and later transplanted in the patient. Blood and cord blood transplants differ from marrow transplants principally in the source of the cells collected for transplant. Imatinib mesylate (Gleevec®) is now the drug of choice in newly diagnosed patients with chronic myelogenous leukemia (CML). marrow and immune system. lymphoma or myeloma is attacked and suppressed by donor lymphocytes that form from the donor stem cells.org/). Regular examinations may include screening for cancer recurrence or the development of secondary cancer or other late effects of treatment. New Approaches to Treatment Several areas of research have resulted in new approaches to the treatment of leukemia. Identifying these biomarkers will allow researchers to develop tests that can predict what effects an individual is at risk of developing.childrensoncologygroup. This still experimental approach greatly lessens the early toxicity of transplantation and has extended the age at which recipients with leukemia. donors of blood stem cells require special treatment to mobilize sufficient stem cells from marrow into their blood before cells are harvested. several important new drugs and new uses for existing drugs have greatly improved cure rates or remission duration for some patients with leukemia. Development of New Drugs: In the past decade. or genetic factors that can increase susceptibility to certain effects. To ensure there will be enough blood stem cells for successful transplantation. In standard stem cell transplantation. Adolescent. lymphoma or myeloma and permit the donor’s cells to be accepted by the temporarily immunodeficient recipient. Follow-Up Care Regular medical follow-up enables doctors to assess the full effect of therapy. “Ablation” referred to wipingout the recipient’s cancer. is a source of stem cells for transplantation. In nonablative transplantation. two second-generation agents. Most follow-up clinics specialize in pediatric cancer survivors. Gleevec offers several dramatic advantages to patients: oral administration. Cancers (http://www. This “graft versus leukemia or lymphoma effect” can suppress (cure) the malignancy and is a prolonged (indefinite) form of immunotherapy. identify recurrence of the disease and detect long-term or late effects. and Young Adult LEUKEMIA LYMPHOMA MYELOMA page 3 . the donor’s cells take hold and the patient’s leukemia. 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. making the procedure more tolerable. Cancer survivors should see their primary care physicians for general health examinations and an oncologist for follow-up care related to cancer. lymphoma or myeloma can have an allogeneic transplant. Although a minority of patients have developed resistance to the drug. as well as marrow.
Pentostatin is another effective drug that can be used in patients with hairy cell leukemia who do not respond to cladribine. Rituximab has become an important agent to treat CD20-positive lymphocytic malignancies. Gleevec is not only a very important new agent in the treatment of CML. the most prevalent lymphoma subtype. approved by the FDA for all types of MDS. Immunotherapy: This is a treatment that uses immune cells or antibodies to fight the disease. kill unhealthy bone marrow cells and may help the bone marrow function more normally in MDS patients. Arsenic trioxide also adds to the drugs available to treat this subtype of acute leukemia. thus rituximab is an anti-CD20 antibody. Lenalidomide (Revlimid®). farnesyl transferase inhibitors and reduced-intensity stem cell transplantation. Cladribine induces long-term remissions in nearly 90 percent of patients treated at diagnosis for one week. chronic eosinophilic leukemia (formerly hypereosinophilic syndrome). reducing the need for transfusions in some patients. Clofarabine (Clolar®). 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. Rituximab is an antibody directed at the target CD20 antigen on B-cell lymphoma cells. Early studies indicate the combination of arsenic trioxide and all-trans retinoic acid may be a further advance in the initiation of therapy. immune cell administration and vaccine development. 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). is being used to treat relapsed or refractory acute lymphocytic leukemia (ALL) in children who have received at least two prior therapies. but it can also induce remissions in some cases of acute leukemia. Cell surface antigens have been given a cluster designation (CD) followed by a number. Three types of immunotherapy are being explored: antibody treatment. Revlimid is approved by the FDA in combination with dexamethasone for the treatment of myeloma patients who have received at least one prior therapy. PDGFR or KIT oncoproteins). LEUKEMIA page 4 LYMPHOMA MYELOMA . Alemtuzumab (Campath®) is a monoclonal antibody directed against the antigen CD52 found on T and B lymphocytes. perhaps 20 percent of cases also derive benefit. it has now become an important fifth drug in the R-CHOP–rituximab. although initially used in indolent lymphomas. has improved dramatically with the introduction of cladribine. principally. In May 2006. thalidomide (Thalomid®). It is especially active against the lymphocytes in CLL. Velcade is approved by the FDA for treating people with myeloma who have had at least one prior therapy. and Decitabine (Dacogen®). however. Monoclonal Antibody Therapy: Monoclonal antibodies are laboratory-produced proteins that can be infused into an appropriate patient. Monoclonal antibodies have added to the arsenal of agents that are used for the treatment of patients with lymphoma and leukemia. Azacitidine (Vidaza®). doxorubicin (Adriamycin®). Indeed. approved by the FDA in 2005. Other therapies in clinical research to treat MDS include arsenic trixoxide. 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. lymphoma or myeloma. Food and Drug Administration [FDA] in 2006) and nilotinib (in clinical trials). 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®). 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. are entering clinical use and can overcome this resistance in some cases.dasatinib (Sprycel®)(approved by the U. and enhances the specificity of treatment to minimize toxic effects on normal tissues. The treatment of hairy cell leukemia. a less common type of chronic lymphocytic leukemia (CLL). vincristine (Oncovin®) and prednisone–therapy for diffuse large B-cell lymphoma. in combination with dexamethasone. In patients with anemia. but without this specific chromosome 5 abnormality. Patients with more severe forms of MDS are very unlikely to respond to the agent. suppresses the progression of 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. a thalidomide derivative. Some patients with moderately severe. was approved by the FDA for newly diagnosed myeloma. such as follicular lymphoma.S. symptomatic anemia have improvement in hemoglobin levels with this agent. cyclophosphamide. This drug is also being tested in clinical trials to treat adult acute leukemia and MDS.
lymphoma or myeloma cells. drugs are designed to interfere with the oncoprotein and prevent its effect on the cell. a technique that prepares small molecules in the laboratory that have the ability to inactivate proteins that cause disease. Reversal of Multidrug Resistance: The malignant cells of patients have mechanisms that may allow them to escape the damaging effects of chemotherapy agents. These cells are. Patients with myeloma have also had remission re-induced by donor lymphocytes. These drugs have been approved to treat relapsed B-cell non-Hodgkin lymphoma. Vaccines: Experimental treatment vaccines are now being studied to treat certain types of lymphoma. b) a modality that uses molecules of RNA to silence complementary (DNA) genes. DNA vaccines that contain the DNA that encodes the specific antigen are being tested. If the gene in the former case is an oncogene or the protein in the latter case is an oncoprotein. 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. myeloma and leukemia. These agents can act on the gene (DNA) or on RNA to prevent the formation of the gene product or protein (oncoprotein) that is the direct cause of transforming the cell into a malignant type. 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. lymphoma and myeloma. new forms of cancer therapy may be developed. is approved for older patients with AML who relapse after initial treatment. Paradoxically. These are called conjugated monoclonal antibodies. Two new and potentially important approaches include a) the application of RNA interference. cells are isolated in the laboratory and start making antibodies after insertion of the cancer antigen.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. Many cancer treatment vaccines under development are intended to induce antigen-specific antitumor immune responses. The goal of several new agents being studied is to decrease resistance to an important chemotherapy drug used in leukemia. Studies of vaccines used in patients with follicular or indolent lymphoma have demonstrated an immune response. gemtuzumab (Mylotarg®). They deliver the toxic substance directly to the cancer cells. This drug. 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. In studies of CML. 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. or become. In another approach. In patients with CML who have relapsed after stem cell transplantation. and aptamer treatment. These antibodies are injected into the patient in the hope that the antibodies will latch on to the antigen on the cancer cells and destroy the cells. LEUKEMIA LYMPHOMA MYELOMA page 5 . In one approach. Examples of this treatment are the drugs ibritumomab (Zevalin®) and tositumomab and iodine I131 tositumomab (Bexxar®). This means that the vaccine induces an immune response against the cancer cells present in the patient. The goal is to extend the duration of remission achieved by remissioninduction therapy of various types. the infusion of the original marrow donor’s lymphocytes can re-induce remission. the basis for the vaccine is to make the cancer cells susceptible to immune attack by heightening the recognition of markers on the cancer cells. In each case. Approaches to reversing multidrug resistance are under study. 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. In some approaches. less responsive to therapy. 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. 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. Monoclonal antibodies can also be linked to a radioactive isotope to target and kill specific cancer cells.
Leukemia is divided into four categories: myelogenous or lymphocytic. red blood cells and white blood cells.800 children. based on the November 2006 SEER data submission. 2004 Type Chronic lymphocytic leukemia Chronic myelogenous leukemia Acute lymphocytic leukemia Acute myelogenous leukemia Prevalence* 95.S. Table 3: Source: Cancer Facts & Figures 2007.720 44. • The most common form of leukemia in children is acute lymphocytic leukemia (ALL).440 Table 2: Sources: SEER (Surveillance. 2007. and End Results) Cancer Statistics Review 1975-2004.579 21.S.410 4. Anemia. • About 33 percent of cancers in children aged 0-14 years are leukemia • Most cases of chronic myelogenous leukemia (CML) occur in adults. American Cancer Society.440 adults compared with 3. Only 2.150 24. The incidence rates are usually presented as a specific number per 100. Leukemia is expected to strike more than 10 times as many adults as children in 2007.240 Male 3.570 3.Leukemia Leukemia is a malignant disease (cancer) of the bone marrow and blood. Approximate U. The marrow often no longer produces enough normal platelets. LEUKEMIA page 6 LYMPHOMA MYELOMA . 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. released April 2007.790). Acute leukemia is a rapidly progressing disease that results in the accumulation of immature. *Note: Incidence rates are the number of new cases in a given year not counting the preexisting cases. DCCPS. In 2007. Estimated 29-Year L-D Prevalence Counts on 1/1/2004 by Duration. functional cells to be made.501 50. Chronic leukemias account for 7 percent more of the cases than acute leukemias. A shortage of platelets results in bruising and easy bleeding. Nearly 54 percent of the new cases of this disease will occur among children in 2007 (about 2. more than half of all cases occur after age 67.140 6. 1. a deficiency of red cells. • Most cases of leukemia occur in older adults.240 new cases of leukemia will be diagnosed in the United States this year.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. Prevalence of the Four Major Leukemias as of Jan. and SEER Program. Incidence by Gender Incidence rates* for all types of leukemia are higher among males than among females.060 2. It is characterized by the uncontrolled accumulation of blood cells. 2007.000 2. Epidemiology.350 2. Prevalence database: U.189 27.570 5. aged 0-19. Statistical Research and Applications Branch.800 Female 2. New Cases An estimated 44. develops in virtually all leukemia patients.200 15.000 population. Surveillance Research Program. functionless cells in the marrow and blood.960 7. The four major types of leukemia are shown in Table 1. Chronic leukemia progresses more slowly and allows greater numbers of more mature.340 13.060 8. National Cancer Institute.380 6.4 percent of leukemias in children aged 0-19 are CML. NCI. males are expected to account for 56 percent of the new cases of leukemia. (About 40. The lack of normal white cells impairs the body’s ability to fight infections.570 19.659 people in the United States are living with leukemia.) • The most common types of leukemia in adults are acute myelogenous leukemia (AML) and chronic lymphocytic leukemia (CLL). each of which can be acute or chronic. The terms myelogenous or lymphocytic denote the cell type involved. *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.
Leukemia rates are substantially higher for Hispanic. From 1975 to 2000. Although chronic exposure to benzene in the workplace and exposure to extraordinary doses of irradiation can be causes of the disease. They do warrant medical evaluation. Possible Causes of Leukemia Anyone can get leukemia. The incidence of ALL among 1. Leukemia is one of the top 15 most frequently occurring cancers in minority groups. American Cancer Society. Children. However.619 with ALL.922 cases per year.to 4-year-old children is more than nine times greater than the rate for young adults ages 20 to 24. Most children under 15 years of age with ALL are cured. Figure 3: Source: Cancer Facts & Figures 2007. Some people with chronic leukemia may not have major symptoms and are diagnosed during a medical examination. The cause of leukemia is not known. 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 incidence is highest among whites and lowest among American Indians/Alaskan natives. 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.to 29-year olds.5 times that of ALL. These signs are not specific to leukemia and may be caused by other disorders. In the 17 SEER regions of the United States. CLL incidence increases dramatically among people who are aged 50 and older. About 2. In 25. 2007. leukemia rates are higher in Americans of European descent than among those of African descent.800 children will be diagnosed with leukemia throughout the United States. from 2000-2004. The incidence rate for all cancers among AfricanAmericans in the Seer (17 region).799 children under the age of 20 diagnosed with leukemia from 2001-2004. and AML incidence increases dramatically in people who are aged 60 and older. CML incidence also increases dramatically among people who are aged 60 and older. neither explains most cases. averaging about 189.to 19-year olds. Leukemia strikes all ages and both sexes.790 new cases of childhood ALL are expected to occur in 2007. Adolescents and Young Adults. Hispanic children of all races under the age of 20 have the highest rates of leukemia.000 population. Other 13% ALL 12% CM L 10% CLL 35% A ML 30% There is optimism within centers that specialize in the treatment of children because survival statistics have dramatically improved over the past 30 years. The American Cancer Society estimates that there will be approximately 152.Estimated Proportion of New Cases (%) in 2007 for Each Type of Leukemia Including Adults and Children 3. was 504 per 100. American Indian/Alaskan natives.900 new cases of cancer diagnosed in African-Americans in 2007. Adults. ALL incidence was approximately twice that of AML. The diagnosis of leukemia requires specific blood tests. the incidence of AML slowly rose while that of ALL steadily decreased in the period from late adolescence to older adulthood. Incidence by Age-Group Incidence rates by age differ for each of the leukemias. AML incidence was approximately 1. LEUKEMIA LYMPHOMA MYELOMA page 7 . including 3. The leukemias represented 27 percent of all cancers occurring among children younger than 20 years from 2000-2004. there were 4. These cancers are most prevalent in the seventh. eighth and ninth decades of life. It is estimated that in 2007. white and Asian/Pacific islander children than for black children. Among 15. The most common form of leukemia among children under 20 years of age is ALL. including the examination of the cells in blood or marrow.
the five-year relative survival rate had jumped to 35 percent. Treatment of Leukemia The aim of treatment is to bring about a complete remission.5 21. the five-year relative survival rates overall were: • ALL: 65. race and type of leukemia. 90.Age-Specific Incidence Rates for Acute Myelogenous Leukemia (All Races).000) 17 15. By 1975-1977.6 2.4 percent for children under 5 • CLL: 74. 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.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. a patient had a 14 percent chance of living five years. 2007.2 15 13 11 9 7. Relapse indicates return of the cancer cells and the return of other signs and symptoms of the disease. National Cancer Institute. LEUKEMIA page 8 LYMPHOMA MYELOMA . gender.3 3.4 5-9 0.4 <1 0. National Cancer Institute. when compared to a person without leukemia. 2007. All Types Leukemia. 54.9 20-24 0.8 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.7 7 5 3 1 0 1.3 1.1 4. In 1960-1963.2 1. Epidemiology and End Results) Cancer Statistics Review 1975-2004. the overall relative survival rate was nearly 50 percent.6 10-14 0. During 1996-2003.7 percent overall.2 10.9 25-29 1.1 Incidence (per 100. Thirty-two percent more males than females are living with leukemia.1 for children under 15 • CML: 44.9 15-19 0. Survival Rates 40% 30% 20% 10% 0% 35% 1975-77 1978-80 1981-83 1984-86 1987-89 1990-92 1993-95 1996-2003 Years Figure 5: Sources: SEER (Surveillance. For acute leukemia. a complete remission (no evidence of disease in the blood or marrow) that lasts five years after treatment often indicates cure.8 1-4 0.2 23 21 19 19. Epidemiology and End Results) Cancer Statistics Review 1975-2004. and in 1996-2003. The five-year relative survival rate has more than tripled in the past 47 years for patients with leukemia. The relative survival rates differ by age of the patient at diagnosis. 2000-2004 25 23.3 percent overall.4 percent Five-Year Relative Survival Rates for All Ages. Complete remission means that there is no evidence of the disease and the patient returns to good health with normal blood and marrow cells.
390 21. National Cancer Institute. 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. 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.470 females. Despite this decline. 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. 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. 2007.990 490 6.470 Table 4: Source: Cancer Facts & Figures 2007. Deaths It is anticipated that approximately 21. 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. In 2007. Zuelzer WW. Epidemiology and End Results). 1975-2004. 2.500 8.420 4.560 5.500 deaths from CLL and 1. Cancer Statistics Review. Non-Hispanic whites diagnosed with leukemia over the age of 44 had the highest death rates during this period.390 additional deaths. 2007. SEER (Surveillance. unclassified forms of leukemia Total Overall 1.420 deaths from ALL.940 3.790 Male 820 2.990 deaths from AML and 490 deaths from CML. Hispanics with leukemia who are under the age of 25 had the highest mortality rates from the disease between 1990 and 1999. There will be an estimated 8. Blood.Five-Year Relative Survival Rates for Acute Lymphocytic Leukemia. LEUKEMIA LYMPHOMA MYELOMA page 9 .680 12.710 9.970 250 2.790 deaths in the United States will be attributed to leukemia in 2007: 12.320 males and 9. 1964:24:477-494. about 515 children under the age of 14 are expected to die from leukemia.020 240 3. leukemia causes more deaths than any other cancer among children and young adults under age 20. In 2007. 1964-2003 90% 80% 70% 60% 58% 71% 66% 73% 78% 83% 84% 87% The estimated numbers of deaths attributed to leukemia in the United States are 30 percent higher for males than for females. deaths from leukemia are expected to be distributed in the following numbers: In 2007. Sources: 1.320 Female 600 1. American Cancer Society. There will be an estimated 4. Implications of long-term survivals in acute stem cell leukemia of childhood treated with composite cyclic therapy. in Children Under 15 Years of Age.
or low. including the presence of an abnormal cell called the ReedSternberg cell (a large.000 at ages 20 to 24 for males and 1. there are 138. incidence rates for non. eventually crowding out healthy cells and creating tumors that enlarge the lymph nodes or other sites in the body. 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. Hodgkin lymphoma has characteristics that distinguish it from all other cancers of the lymphatic system.670 Female 3.313 people living with Hodgkin lymphoma (active disease or in remission) and 405. New Cases About 71.266 members of the U. Incidence rates for Hodgkin lymphoma tend to be higher among males than among females.710 Total 8. and each has prognostic factors that categorize it as more or less favorable. Hodgkin Lymphoma Hodgkin lymphoma is a specialized form of lymphoma and will represent about 11. The groups are often classified as indolent or aggressive. LEUKEMIA page 10 LYMPHOMA MYELOMA .190 cases of non-Hodgkin lymphoma). New Cases of Lymphoma by Gender. Age-specific incidence rates of non-Hodgkin lymphoma are 2. an average annual percentage increase of 2. Non-Hodgkin lymphoma is the fifth most common cancer in males and females in the United States. in general whites have higher incidence rates than blacks.5 percent of all lymphomas diagnosed in 2007.190 63. population who are living with lymphoma.S. 2007.190 71. Non-Hodgkin Lymphoma Non-Hodgkin lymphoma represents a diverse group of cancers with the distinctions between types based on the characteristics of the cancerous cells. Incidence by Gender Table 5 illustrates the breakdown of incidence of lymphoma by gender. The bacterium Helicobacter pylori is associated with the development of lymphoma in the stomach wall.000 for females.9 per 100.9 per 100.7 percent of all cases of non-Hodgkin lymphoma will be diagnosed in children under 15 years of age this year. It is the sixth most common cause of cancer deaths in males and in females.720 28. Living with Lymphoma In the United States in 2007. American Cancer Society.3 per 100. Each histologic grouping is diagnosed and treated differently.6 per 100. The incidence of Hodgkin lymphoma is consistently lower than that of non-Hodgkin lymphoma. the difference was small. Lymphoma results when a lymphocyte (a type of white blood cell) undergoes a malignant change and begins to multiply. Persons infected with the human immunodeficiency virus (HIV) have a much higher risk of developing lymphoma.000 for males and 38. Immune suppression plays a role in some patients.000 for females. By ages 60 to 64.990 32. These risk factors explain only a small proportion of cases.8 percent. while 0.470 34.Hodgkin lymphoma are higher in Americans of European descent than among those of African descent.380 Table 5: Source: Cancer Facts & Figures 2007. After 50 to 54 years of age.190 cases of Hodgkin lymphoma and 63.Lymphoma Lymphoma is a general term for a group of cancers that originates in the lymphatic system. Fifty-three percent of the blood cancers diagnosed are lymphomas. The reasons for the development of non-Hodgkin lymphoma are not certain. The Epstein-Barr virus causes Burkitt’s lymphoma in Africa. 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. they are 52. malignant cell found in Hodgkin lymphoma tissues).200 38. rose by 84 percent from 1975 to 2004. intermediate and high grade. Both Hodgkin and non-Hodgkin lymphomas are more common in males than in females. In 2004.953 people living with nonHodgkin lymphoma for a total of 544. 2007 Type Hodgkin lymphoma Non-Hodgkin lymphoma Total Male 4.
and non-Hodgkin lymphoma. About 2. 4. excessive tiredness. lymphomas are most commonly diagnosed in whites (24. about 10. Incidence in Adults The incidence of non-Hodgkin lymphoma increases with age.000 children in 2004. the highest incidence of non-Hodgkin lymphoma is in Asian/Pacific islanders. In the United States. and is the eighth most common cause of cancer death in that group. loss of appetite and bone pain. widespread disease requires chemotherapy or chemotherapy and/or monoclonal antibody therapy with radiation.1 cases per 100. The five-year relative survival rate for non-Hodgkin lymphoma patients has risen from 31 percent in whites in 1960-1963 to 63. five-year relative survival for non-Hodgkin lymphoma is now 83. The most common early sign of other forms of lymphoma is also painless swelling of the lymph nodes – usually in the neck. Non-Hodgkin lymphoma is the fifth most common cancer in Hispanics. Even in the mid-1970s. persistent fatigue. Survival for Adults Hodgkin lymphoma is now considered to be one of the most curable forms of cancer. The five-year relative survival rate for patients with Hodgkin lymphoma has more than doubled from 40 percent in whites in 1960-1963 to more than 86 percent for all races in 1996-2003. troublesome itching and weight loss.070 from Hodgkin lymphoma). groin or in the abdomen. Non-Hodgkin lymphoma is the ninth most common cause of cancer death in males and the seventh in females in the United States.5 percent.400 children under the age of 15 will be diagnosed with cancer in 2007. The incidence in this group decreased almost steadily and significantly between 1975 and 1999.5 percent) are the third most common cancers in children.2 percent for Hodgkin lymphoma in people under 20 years of age. Signs and Symptoms Signs and symptoms of Hodgkin lymphoma include painless swelling of lymph nodes in the neck. Incidence in Children The incidence of Hodgkin lymphoma among people under 20 years of age was 1.to 24year-old individuals. localized non-Hodgkin lymphoma is sometimes treated with radiation. followed closely by Hispanic children of all races (24.660 from non-Hodgkin lymphoma.000 persons at ages 80 to 84. Hispanics of all races have the second highest incidence rates of non-Hodgkin lymphoma after whites. cell type and location of the lymphoma.8 percent for all races in 1996-2003. In children under 20 years of age. Radiation. In children up to age 14 years.1 per 100. comprising nearly 5 percent of all cancers diagnosed.730 persons will die from lymphoma in the United States in 2007 (18. armpit or groin. Deaths An estimated 19.9 percent). depending on the tumor size. and more than 46-fold to 112. Symptoms also often include fever. the highest incidence of non-Hodgkin lymphoma is in non-Hispanic whites.5/1 million population). Lymphomas (Hodgkin lymphoma. LEUKEMIA LYMPHOMA MYELOMA page 11 . chemotherapy or both may result in cures for most patients with Hodgkin lymphoma. Survival for Children Five-year relative survival is 95. most children with nonHodgkin lymphoma did not live five years after diagnosis. Early stage. Treatment Hodgkin lymphoma is often treated with radiation and chemotherapy. Hodgkin lymphoma incidence rates are higher in adolescents and young adults than in adults in their middle years.000 people occur in 20.8 percent) and neoplasms of the brain and other nervous tissue (17.Among women.0/1 million population). This represents a significant improvement in the rate of recovery. indigestion and abdominal pain.000 by ages 60 to 64. It is rarest among American Indian/ Alaskan native children. following leukemia (26. sweating at night.5 percent. In children from 0 to 19 years of age. armpit. The rate increases more than 18 times to 45.4 cases per 100. It has remained fairly constant since 1999. recurrent high fever. Five-year relative survival is now 95 percent for Hodgkin lymphoma in children aged 0 to 14 years. night sweats.1 cases per 100. Treatment for non-Hodgkin lymphoma sometimes includes vaccines and other forms of immunotherapy. Adolescents are more commonly diagnosed with Hodgkin lymphoma than young children. 3. Death rates have been declining for Hodgkin lymphoma patients since the mid-1970s. From ages 15 to 19. 1.
Epidemiology and End Results) Cancer Statistics Review 1975-2004.0 45.6 0.370 Female 300 9.1 4. Epidemiology and End Results) Cancer Statistics Review 1975-2004.0 20 10 0 0.1 102.3 4. Table 6: Source: SEER (Surveillance.4 4.4 80. 2007.1 63. LEUKEMIA page 12 LYMPHOMA MYELOMA .5 <1* 1-4 5-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 Age in Years 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85+ Figure 8: Sources: SEER (Surveillance. Epidemiology and End Results) Cancer Statistics Review 1975-2004. American Cancer Society.4 2.4 2.0 2.070 18.1 3. *<16 cases per time interval. 2007.0 1. * <16 cases for time interval.9 1.Age-Specific Incidence Rates for Hodgkin Lymphoma.6 32.3 <1* 1-4 5-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85+ Age in Years Figure 7: Sources: SEER (Surveillance.1 3.2 1.000) 5 4 3 2 1 0 0.660 19. 2000-2004 6 Incidence (per 100.4 2. 2007.060 9.8 2.8 112.2 4. Age-Specific Incidence Rates for Non-Hodgkin Lymphoma. 2000-2004 110 100 90 80 Incidence (per 100. National Cancer Institute.0 0.0 3.8 4.8 3. National Cancer Institute.730 Male 770 9.360 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 2007.000) 70 60 50 40 30 22.600 10.9 4. 2007. Trends in Five-Year Relative Survival Rates by Race for Hodgkin Lymphoma and Non-Hodgkin Lymphoma Hodgkin Lymphoma All races Whites African-Americans 1975-77 1981-83 74% 74% 71% 76% 76% 73% 1990-92 1996-2003 83% 84% 74% 86% 87% 81% Estimated Deaths by Gender from Hodgkin Lymphoma and Non-Hodgkin Lymphoma Type Hodgkin lymphoma Non-Hodgkin lymphoma Total Overall 1.9 3.4 2.9 7.1 0.0 100.1 0. National Cancer Institute.5 10.4 15.4 3.
940 women) new cases of myeloma will be diagnosed in the United States in 2007.000) of myeloma than those of European descent (5. From 2000 to 2004.Myeloma Myeloma is a cancer of the plasma cells. and it rarely occurs in people under age 45. 5-9. has been increasing.4 33.3 0. Myeloma was the 10th most common cause of cancer deaths for women in 2000-2004.S. but primarily in the bone marrow. Patients may have anemia. Malignant plasma cells produce an abnormal protein called monoclonal immunoglobulin. In myeloma. 2007.000). Recurrent infections may be an early sign of the disease. It is 71 for African-Americans. National Cancer Institute. 1-4. It grows continuously and forms masses of plasma cells.000 to 3.000) for all racial and ethnic groups. • Americans of African descent have a much higher incidence rate. The highest rates are found in black men 80 to 84 years of age and older (105/100.4 35. 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. destroying normal bone tissue.000) is 56 percent higher than for women (4.2/100. The mortality rate from myeloma for people of African descent is more than double the rate for whites (7. At times. two or three drugs are used simultaneously.9 9. 2000-2004 Incidence (per 100. median age at death from multiple myeloma is 74. causing pain and crowding out normal blood cell production.8 14. 15-19.3/100.900 (10. Treatment Chemotherapy for myeloma has led to sustained remissions in some patients.000). 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. Treatment may include intensive chemotherapy followed by stem cell transplantation to restore normal blood cell production.1 5. • The incidence rate in men (7/100. Fractures may occur as a result of the weakened bones. a B lymphocyte. The U. 10-14. The onset of myeloma interferes with normal production of antibodies and makes myeloma patients susceptible to infections.5/100. but it is the most difficult blood cancer to treat successfully.1/100. • The median age at diagnosis for African-Americans is 67.1 0. Age-Specific Incidence Rates for Myeloma. especially in the marrow. approximately double.0 37. SEER 17 areas (<1. New Cases An estimated 19. 20-24).000) 40 30 20 10 0 0-24 0. Sixty percent of those were diagnosed with the disease within the past four years. Usually. Treatment is aimed at slowing progress of the disease.5/100.7 1. Living with Myeloma An estimated 60.1 21. (11. the patient’s own stem cells are used (autologous stem cell infusion). Total survival for white males. especially. Epidemiology and End Results) Cancer Statistics Review 1975-2004. the cell that forms plasma cells.960 men and 8.1 Signs and Symptoms Often the first symptom of myeloma is bone pain caused by the effects of myeloma cells in the marrow. a type of white blood cell found in many tissues of the body.424 people in the United States are living with myeloma. Deaths Approximately 10. Figure 9: Source: SEER (Surveillance.000). Thalidomide is approved by the FDA for use in treating newly diagnosed myeloma. tire more easily and feel weak. becomes malignant. Approximately 3 percent of all cancer-related deaths among AfricanAmericans in 2000-2004 were from myeloma. *<16 cases for each age interval.1 28. 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.790 deaths from myeloma are anticipated this year. LEUKEMIA LYMPHOMA MYELOMA page 13 . myeloma was the 10th most commonly diagnosed cancer among African-American men and women. Bortezomib has been approved for treating myeloma in patients who have had at least two prior therapies.5 3. • The median age at diagnosis is 70. Lenalidomide is approved by the FDA in combination with dexamethasone for the treatment of myeloma patients who have received at least one prior therapy.
0 Female 9.000 Population (2000-2004) Type Leukemia Non-Hodgkin lymphoma Hodgkin lymphoma Myeloma Overall 10.) Incidence Rates by Gender.3 2.1 11.6 4. Lymphoma and Myeloma The following tables showing incidence rates for leukemia.000 population and are age-adjusted to the 2000 population.9 2. (Based on SEER 17 areas.2 14.8 20.1 9.6 Male 16.6 2.1 Table 10: Source: SEER (Surveillance.5 Table 8: Source: SEER (Surveillance. per 100.1 2. for Whites. Epidemiology and End Results) Cancer Statistics Review 1975-2004. All Races.9 17.2 18.3 Male 13.0 2. (Based on SEER 17 areas.0 Female 8. per 100. per 100.3 2.0 23. Rates are per 100.2 2. (Based on SEER 17 areas.000 Population (2000-2004) Type Leukemia Non-Hodgkin lymphoma Hodgkin lymphoma Myeloma Overall 12. for Blacks. 2007.9 5.6 Female 9.1 3.7 5.) Table 9: Source: SEER (Surveillance. 2007.4 4.3 19. National Cancer Institute.) LEUKEMIA page 14 LYMPHOMA MYELOMA . National Cancer Institute.8 14.7 24.0 7. Epidemiology and End Results) Cancer Statistics Review 1975-2004.5 Incidence Rates by Gender.5 16.2 3. Hodgkin and non-Hodgkin lymphoma and myeloma use figures from 2000-2004. Epidemiology and End Results) Cancer Statistics Review 1975-2004. National Cancer Institute. Incidence Rates by Gender.4 11.2 6. the most recent available.2 Male 16.Incidence Rates: Leukemia. 2007.000 Population (2000-2004) Type Leukemia Non-Hodgkin lymphoma Hodgkin lymphoma Myeloma Overall 12.
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 2.630 540 80 120 990 510 310 230 320 330 100 390 490 770 400 210 460 80 150 160 100 680 120 1.680 920 340 890 170 290 330 190 1. **State estimates may not add up to U. total because of rounding and exclusion of estimates that are fewer than 50 cases..190 290 * 280 200 1. Numbers are rounded to the nearest 10. Used with permission.550 2.330 260 780 180 1.010 1. by State.140 380 140 1. ***Hodgkin lymphoma estimates are not available for 2007. 2007 State Leukemia Non-Hodgkin Lymphoma Myeloma Hodgkin Lymphoma*** Estimated Deaths from Blood Cancers by Site.030 910 620 420 680 680 250 630 1. which is new for 2007.070 Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Dist.710 570 500 2.500 430 1. by State. Note: These estimates are offered as a rough guide and should be interpreted with caution. January/February 2007. 2007 State Leukemia Non-Hodgkin Lymphoma Myeloma Hodgkin Lymphoma Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Dist. *Estimate is fewer than 50 cases.610 150 2.140 60 260 80 410 1.Estimated New Cases of Blood Cancers by Site. American Cancer Society. is described by Pickle et al.170 480 1.390 1.S.670 1. 1969-2004.370 100 * 430 380 130 350 * 19.080 1.250 1. and additional data supplied by the American Cancer Society.080 600 7. CA A Cancer Journal for Clinicians. numbers are small and NCI and ACS are having difficulty fitting them into the Pickle et al.070 110 1.790 330 * 320 200 1. Centers for Disease Control and Prevention.540 1. model (see below). Mortality Public Use Data Tapes.200 350 4. 2006.550 * * * * *20 * * * * 60 * * * 50 * * * * * * * * * * * * * * * * * * 70 * * 50 * * 60 * * * * 80 * * * * * * * 390 Table 11: Sources: Cancer Facts & Figures 2007.050 140 140 * * 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 * 10.180 4. Note: These estimates are offered as a rough guide and should be interpreted with caution.240 740 80 1.150 290 270 70 * 1.410 130 50 500 490 130 490 * 21.370 250 280 2.300 470 90 100 750 430 300 220 290 310 110 320 420 660 350 170 500 80 110 130 90 600 120 1.410 560 * 740 230 230 930 70 300 50 350 1. of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Total** 550 70 740 510 4. **State estimates may not add up to U.S.040 70 44.560 770 890 3.160 140 50 360 440 170 320 * 18. and additional data supplied by the American Cancer Society based on data from the U.360 610 * 950 290 260 1. *Estimate is fewer than 50 cases.240 170 550 130 800 3. National Center for Health Statistics. They cannot be compared with previous years’ estimates to determine cancer incidence trends. Numbers are rounded to the nearest 10.660 210 * 190 120 1. The method of derivation.520 310 3.530 1.130 300 80 900 960 300 1. American Cancer Society.300 110 63.160 1.610 670 610 110 60 3. LEUKEMIA LYMPHOMA MYELOMA page 15 .070 80 330 70 480 1. Table 12: Sources: Cancer Facts & Figures 2007. total because of rounding and exclusion of estimates that are fewer than 50 cases.190 880 870 170 100 4. 2007.830 240 230 60 * 1.510 500 60 70 900 380 220 160 280 430 100 370 460 730 310 170 400 70 110 120 80 650 120 1. 2007.360 960 170 220 2.260 220 400 420 290 2. Used with permission.S.310 800 600 900 920 330 1.880 240 250 50 50 1.030 570 * 610 210 360 1.
S.. estimates of cancer incidence. but these figures do not take into account differences in geography. When expressed as a rate.S. It includes new (incidence) and preexisting cases and is a function of both past incidence and survival. The data can be extrapolated for the entire United States by multiplying by the population ratio. if a person is initially diagnosed with melanoma and later develops leukemia. based on the “first invasive tumor for each cancer site diagnosed during the previous 29 years (1975-2003). the data presented in the 2007 SEER report placed online on April 15. in some cases fewer than 17 SEER regions) and death data from the National Center for Health Statistics. It considers deaths from all causes. Census. no matter how long ago that diagnosis was. CA A Cancer Journal for Clinicians. especially in looking at populations in which individuals have had more than one type of cancer. so the exact number of cases is not known. The description of the methods used was published in Pickle et al.S. 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. Epidemiology and End Results Program (SEER) regions (or. Prevalence may be calculated in a number of different ways. population) that belong to the National Program of Cancer Registries. cancer or otherwise. in comparison to the 2002 SEER report. it is the number of new cases per standard unit of population during the time period. may be incomplete in some cases and the data may reflect adjustments that anticipate changes that will occur once the actual data are received. only the first diagnosed cancer counts. 2007. January/February 2007. population.Notes and Definitions Notes The United States does not have a nationwide reporting system or registry for blood cancers. survival and mortality have been revised. Because of changes in the information — such as racial classification — gathered in the 2000 U. 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. This change means that the 2007 incidence estimates are not comparable with previous estimates for determining cancer incidence trends. (Observed survival is the actual percentage of patients still alive at some specified time after diagnosis of cancer. Thus. 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.) Prevalence is the estimated number of people alive on a certain date in a population who previously had a diagnosis of the disease. In this report. race or sex. Bureau of the Census’ 2000 population data for that region. The relative survival rate is a comparison of survival to a person who is free of the disease.” as per SEER table I-21. Relative survival rate is an estimate of the percentage of patients who would be expected to survive the effects of the cancer. This year. state-by-state data for incidence of Hodgkin lymphoma are not available because these numbers are so small. The specified date is 1/1/2004 for the prevalence estimates. mostly upward. Thus. LEUKEMIA page 16 LYMPHOMA MYELOMA .” We are using the “29-year limited duration” prevalence figures. the American Cancer Society changed its method of estimating cancer incidence. his or her survival with leukemia may not be counted in leukemia prevalence 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. 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.S. prevalence numbers reported may vary depending upon the method used to determine them. Because of this change in method. race and ethnicity in various regions and region-specific health risks. In some prevalence statistics. The SEER (17 region) data cover only about 26 percent of the U. The data presented in this report are an extrapolation or estimate of the number of cases reported by the 17 Surveillance. 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. Because of reporting delays from some of the SEER regions. Incidence rates can be calculated based on a number of factors such as age.
20-37. Including SEER Incidence and Survival: 1975-2000. 2006. Edwards BK (eds). Clegg L. 2006. 12. Krapcho M. Nachman J. Tiwari RC. pp. based on November 2006 SEER data submission. http://caonline. Eisner MP. Stock W. National Cancer Institute. O’Leary M. Feuer EJ. “A New Method of Estimating United States and State-Level Cancer Incidence Counts for the Current Calendar Year. 174. CA A Cancer Journal for Clinicians Vol. In Cancer Epidemiology in Older Adolescents and Young Adults 15 to 29 Years of Age. http://seer. Jemal A. No. Ries LAG (eds). Atlanta: American Cancer Society.cancer. “Cancer Statistics. Howe HL. Horner MJ. Epidemiology. January. 25-38. posted to the SEER Web site 2007. MD. Ross J. Barr R. No. Melbert D. Barr R. In Cancer Epidemiology in Older Adolescents and Young Adults 15 to 29 Years of Age. 2007. Ries LAG (eds). MD. National Cancer Institute. Bethesda. Hachey M. Zou Z. January/February. Trends.gov/csr/1975_2004/ LEUKEMIA LYMPHOMA MYELOMA page 17 . “Lymphomas and Reticuloendothelial Neoplasms. MD. MD.TheOncologist. Bleyer A. Ries LAG (eds). pp. 30-42. Sheaffer J.” Bleyer A. http://www. Reichman M. 1975-2004. Ries LAG. “Highlights and Challenges. and End Results) Cancer Statistics Review. NIH Pub.” Mattano L Jr. NIH Pub. Barr R. Including SEER Incidence and Survival: 1975-2000. “Leukemias. Shu X-O. Barr R. National Cancer Institute. Ward E. Edwards BK. No. 2007. Cancer Facts & Figures for African Americans 2007-2008. Bleyer A. Including SEER Incidence and Survival: 1975-2000. Bethesda. 39-51. Epidemiology. p. 06-5767. Cheson B.amcancersoc.com/cgi/content/full/12/1/20. National Cancer Institute. Miller BA. Keller F. O’Leary M. SEER (Surveillance. Bleyer A. Mariotto A. 065767. Atlanta: American Cancer Society. 2006. O’Leary M. pp.” O’Leary M. Howlander N. Bethesda. Bethesda.Citations Source Citations Cancer Facts & Figures 2007. and End Results (SEER) Program.” Pickle LW. NIH Pub. 065767. pp. Howlader N. 2007. 2007. The Oncologist Vol. 57. and Multiple Primary Cancer Analyses from the Surveillance. In Cancer Epidemiology in Older Adolescents and Young Adults 15 to 29 Years of Age. Reichman ME.” Hayat MJ. Feuer EJ. Hao Y.org/cgi/content/full/57/1/30.
to a total cost of $6. Each SCOR is funded up to $1. lymphoma and myeloma research comprise four review subcomittees.25 million. The SCOR program brings together research teams working in complementary areas. Translational Research • Scholars in Clinical Research are awarded $110. • Special Fellows are awarded $60. leading to better survival rates and prevention measures for patients. Translational Research Program The Translational Research Program provides early-stage support for research on leukemia.25 million per year over a five-year period.000 a year for a total of $180. The program is expected to generate new knowledge and breakthrough discoveries.6 million annually on research.000 a year for a total of $550. Funding for two additional years may be provided for highly promising projects that are entering phase I clinical trial. The Specialized Center of Research (SCOR) in Leukemia. The participating scientists may be at different institutions or from any country. Research grants are awarded in three program areas: Career Development. lymphoma and myeloma that is intended to advance treatment. 3) Translational Research Program. for a total of $600.000 over five years. • Special Fellows in Clinical Research are awarded $60. Since the first funding in 1954.000 over five years. research reaching a clinical trial can receive $1 million over five years to facilitate new drug discovery or advances in diagnosis or prevention. Now supporting $61. treatment or prevention of leukemia. Translational Research Awards are made for an initial three-year period.About the Society The Leukemia & Lymphoma Society is the world’s largest voluntary health organization dedicated to funding blood cancer research and providing education and patient services. the Society has awarded more than $550 million in research grants. The Grant Review Process Scientists and physician-scientists who are experts in the field of leukemia. 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. Research Research Grant Programs The Society’s research programs are based on the belief that all scientifically sound approaches toward a cure for. Hodgkin’s disease and myeloma. are granted each year. 2) CDP-clinical research. lymphoma and myeloma. Translational Research and the Specialized Center of Research (SCOR). and improve the quality of life of patients and their families.000 over three years.000 over three years. The Society is a nonprofit organization that relies on the generosity of individual and corporate contributions to advance its mission. Career Development Program The Career Development Program supports promising young scientists (Scholars. Awards go to those groups that best demonstrate the synergy that will occur from their close interaction. 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 . leukemia. lymphoma and myeloma should be encouraged worldwide. Awards up to $200. diagnosis or prevention in the near term. lymphoma.000 a year for a total of $180. • Fellows are awarded $50. Lymphoma and Myeloma These center grants are awarded to a cluster of at least three research groups that interact to foster advances in the diagnosis.000. They are: 1) Career Development Program (CDP)-basic research.000 over three years.000 a year for a total of $550.000 per year for three years. lymphoma or myeloma. We offer a wide variety of programs and services in support of our mission: Cure leukemia. the Society’s grant programs are among the most prestigious in the fields of blood cancers. The SCOR grants also support scientific core laboratories to provide access to innovative technology if required by the participating research programs. each focused on the discovery of new approaches to benefit patients or those at risk for developing leukemia. Thus.000 a year for a total of $150. or control of.
LLS. 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. Educational Materials An extensive collection of free educational materials are offered to patients and health professionals.org. As of June 30. the Translational Research Grant Progress Review Meeting and the SCOR Progress Review Meeting. their families and healthcare professionals.org/copay. The Society also hosts numerous teleconferences and Webcasts. where medical professionals share the latest research findings. The Society’s Web Site The Society’s Web site. Patients needing assistance may apply on the Society’s Web site. on the Society’s Web site. and click “Live Help.org.m.important projects to advance the Society’s mission. 9 a. This support should advance the understanding. LEUKEMIA LYMPHOMA MYELOMA page 19 . www.m.m. Teleconferences and Webcasts The Society sponsors more than 25 educational teleconferences and Webcasts each year on topics of interest to patients and caregivers. lymphoma. Guided by two volunteer oncology health professionals. brochures and videos through the IRC and local Society chapters. Information on registration for these free events can be accessed at www.org or by or emailing researchprograms@LLS.org or faxing to (914) 949-6691 or contacting the Research Department at (914) 949-5213. and applications for the Society’s three research programs may be obtained by visiting www. including support groups. Patient Services The Society has a network of 68 chapters throughout the United States and Canada. Co-Pay Assistance Program Patients with AML. lymphoma and myeloma. www. They are available to talk one-onone. the Society’s programs and services.” Chapter Programs: Family Support Groups: The Society has developed more than 360 Family Support Groups at 68 chapters. Information specialists are oncology social workers and health educators who provide callers with current information on blood cancers. 2007 the Society will have 379 active grantees at 116 institutions in the United States and abroad. www. Monday through Friday. lymphoma. These offices conduct lifeenhancing patient services. families. myelodysplastic syndromes (MDS) and other blood cancers.org. A trained patient volunteer currently in remission phones the new patient to share information and support.org. to 5:00 p. families and professionals may call the IRC toll free at (800) 955-4572 in addition to corresponding by email at infocenter@LLS. The Annual Research Symposium. Professional Education The Society serves the continuing educational needs of the medical and research community through professional symposia offered throughout the year. from 10:00 a.LLS. sponsored by the Society. Other meetings are held for the Society’s grantees. myeloma. is held each December on the Friday immediately before the American Society of Hematology meeting. ET.org.org.LLS. 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. serves a wide variety of education and information needs.LLS. treatment and prevention of leukemia. Each year. First Connection: This program links newly diagnosed patients to a peer volunteer who has experienced a similar diagnosis. Patients. Much of the content of these materials is available to view and download at www. Guidelines. the Society distributes more than 1 million booklets.LLS. Family Support Group locations. instructions.org.LLS. call (877) LLS-COPAY ( 557-2672) or email copay@LLS. These include the Stohlman Scholar Symposium. ET. podcasts and Webcast archives of these programs are available at www. You may also chat online with an information specialist. and encourages greater communication among patients. clinical trials and offer guidance on coping. The site features a comprehensive overview of blood cancers. audio. to 6 p.m. The educational program offers varying formats to facilitate the exchange of information and ideas on the newest developments in cancer research and treatment. The IRC is a worldwide link to information and resources useful to patients. treatments. The Society funds several Focused Workshops each year on important topics relevant to hematological malignancies. friends and healthcare professionals. peer counseling and patient financial aid. each group provides information and support. information about our peer-to-peer program First Connection and other programs. It is continually being updated and expanded to support and promote the Society’s mission.LLS.
treatments. emerging therapies and side effects and addresses the unique challenges of nursing management of these patients. 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. Patient financial aid funds are subject to availability. diagnosis. the Society has helped patients demonstrating a need for financial assistance cover a portion of their treatment costs. 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. treatments. This nursing education program provides an overview of CML. This program is provided through an unrestricted educational grant from Millennium Pharmaceuticals. the Society’s advocacy program has been a strong voice in Washington. In 2002. Advocacy Since 1994. Printed literature. The Trish Greene Back to School Program for Children with Cancer: This program is designed to increase communication among healthcare professionals. 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. treatments and future directions for NHL are also discussed. drugs and various treatments not covered by insurance. This program is made possible by the Lance Armstrong Foundation. patients and school personnel to assure youngsters a smooth transition from active treatment back to school.000 and has become a potent voice in public policy deliberations. representing to policy makers at all levels of government the healthcare quality concerns and medical research interests of patients and their families. LEUKEMIA page 20 LYMPHOMA MYELOMA . reimbursement of up to $500 per year helps cover the costs of transportation. that program has funded some $30 million in additional blood cancer research. Working through chapters across the country. New insights. New Directions in Myeloma Therapy: This program presents an overview of myeloma. This program is being sponsored by an unrestricted education grant from Novartis Oncology. this education program discusses possible emotional and cognitive short. Meet the Expert on Non-Hodgkin Lymphoma: This program presents basic information on terminology. risk factors. The patient education program was funded at $18 million through 2007. 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. It is supported by Amgen Oncology. 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. unrestricted educational grant from Genentech BioOncology and Biogen Idec Inc. This Society program is being supported by Celgene Corporation and Millennium Pharmaceuticals. This program is also accessible as a Webcast at www.Patient Financial Aid Program: For more than 31 years. the Society successfully lobbied Congress to institute a blood cancer research initiative as part of the U. staging and classification of nonHodgkin lymphoma (NHL). CML Issues and Insights: A Nursing Education Program on Chronic Myelogenous Leukemia. how cancer drugs are developed and what the emerging treatment options are for leukemia. lymphoma and myeloma.LLS. and offers numerous resources that can assist childhood cancer survivors to flourish in the school environment posttreatment. In 2001. parents.S. emerging therapies and managing side effects and how to find emotional support when living with the illness. Department of Defense’s medical research program. Society volunteers and staff visit Capitol Hill regularly to lobby Congress in support of issues that impact research and patient care. 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.and long-term effects that children may experience after treatment.org and is being sponsored by a generous. The Society has identified key issues that currently shape its advocacy agenda. On the state level. DC. families and healthcare professionals with a clear description of what clinical trials are. videos and other materials to aid the process are available through all local chapters. The Path to Progress: Clinical Trials in Blood Cancers: This program provides patients. To date. That network now numbers more than 35. Through the Patient Financial Aid Program.
This publication is designed to provide information in regard to the subject matter covered. .Acknowledgements Additional data from SEER*Stat Databases at http://www. of the American Cancer Society (ACS). with the understanding that the Society is not engaged in rendering medical or other professional services.gov. provided ACS’s state-by-state statistics on myeloma and Hodgkin lymphoma. Milton Eisner of SEER.seer.D. for compilation of data for this publication.cancer. The Leukemia & Lymphoma Society extends special thanks to Myrna Watanabe. provided statistical assistance. Ph. It is distributed as a public service by The Leukemia & Lymphoma Society Inc. and Rebecca Siegel.. NCI.
Hodgkin’s disease and myeloma. The Society is a nonprofit organization that relies on the generosity of individual.955. lymphoma.Home Office 1311 Mamaroneck Avenue. and improve the quality of life of patients and their families.LLS Information Resource Center (IRC): 800.4572 www. PS80 35M 6/07 . Suite 310 White Plains. New York 10605 Tel: 888.HELP.org Our mission: Cure leukemia.LLS. corporate and foundation contributions to advance its mission.
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