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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.
• This year. an annual publication. • In general. Highlights from the Report Include: New Cases • An estimated 135. 2nd Edition. • New cases of leukemia. This abnormal accumulation interferes with the production of healthy blood cells. lymphoma and myeloma will cause the deaths of an estimated 52. the likelihood of dying from most leukemias*.3 percent of the deaths from cancer in 2007 based on the 559.349 Americans are living with leukemia.953 either have or are in remission from non-Hodgkin lymphoma (NHL). lymphoma and myeloma. Cancer Statistics Review 1975-2004 (see Notes. Hodgkin and non-Hodgkin lymphoma and myeloma will account for nearly 9. or nearly six people every hour. lymphoma and myeloma in 2007.790 people will die from myeloma. From 1975 to 2004. This statistic represents 143 people each day. 1975-2004. This year. Hodgkin and non-Hodgkin lymphoma.900 people will be diagnosed with myeloma. • Eighty-six percent of myeloma cases occur in people aged 55 and over.520 people in the United States will be diagnosed with leukemia. *Myeloma Biology and Management. The next SEER Cancer Statistics Review is expected to be published online in April 2008.Executive Summary Facts 2007-2008. 405. 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.730 people will die from lymphoma (1. This year.1975-1977 vs. 1998. • Thirty-two percent more males are living with leukemia than females.650 total cancer-related deaths. More males are diagnosed with leukemia and more males die of it than females. Myeloma: • • • • There are 60. 1960-1963 1975-1977 1996-2003 Figure 1: Sources: SEER (Surveillance. 2007 and SEER 19731993. Deaths • Leukemia. www.920 new cancer cases diagnosed in the United States this year. 138.190 cases of non-Hodgkin). • Leukemia causes more deaths than any other cancer among children and young adults under the age of 20. which becomes malignant and multiplies continuously. the incidence of myeloma increased 8 percent. 19. These data were published online by SEER. Leukemia. page 16).seer. and myeloma. 21. • In 2007.190 cases of Hodgkin. • Every 10 minutes. Mortality from the disease increased 24 percent.380 new cases of lymphoma will be diagnosed in the United States (8. LEUKEMIA LYMPHOMA MYELOMA page 1 .444. The data within Facts 2007-2008 reflect the most recent statistics available from SEER. the National Cancer Institute’s Surveillance. Oxford University Press. is a compilation of the most recent data on leukemia. • Every five minutes. in April 2007.790 people will die of leukemia. Epidemiology and End Results Program. National Cancer Institute.659 people in the United States who are either living with or are in remission from leukemia. lymphoma and myeloma decreased from 1995 to 2004 (the last year data were available). Survival • An estimated 823. Five-Year Relative Survival Rates 1960-1963 vs. someone is diagnosed with a blood cancer. 19. • These blood cancers will account for 9.266 people living today with lymphoma. 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. 63. • In 2007.cancer. someone dies from a blood cancer. Epidemiology and End Results) Cancer Statistics Review.310 people in the United States this year.070 from Hodgkin. • This year. 10.660 from non-Hodgkin).313 either have or are in remission from Hodgkin lymphoma. nonacute myelogenous and monocytic leukemias Lymphoma: • There are 544.240 people will be diagnosed with leukemia.gov. National Cancer Institute. and its age-adjusted incidence rose by nearly 84 percent from 1975 to 2004. 1996. 71. *except acute myelogenous leukemia (AML) and other.424 people living today with myeloma. • Non-Hodgkin lymphoma is the fifth most common cancer in the United States. 18. 44.4 percent of the 1.
The technique is important. The stem cells are frozen and later they can be thawed and infused into the patient if intensive chemotherapy and/or radiotherapy is required for subsequent treatment. myeloma and lymphoma are usually treated with chemotherapy.About the Diseases Leukemia. 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. lymphoma and myeloma. usually a brother or sister with the same tissue type. The harvesting. especially in young children. 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. slightly mismatched cord stem cell donors may be used quite successfully. Estimated New Cases (%) of Blood Cancers in 2007 Myeloma 15% Leukemia 33% Lymphoma 53% Treatment Chemotherapy and Radiotherapy: The use of chemotherapy (anticancer drugs). In special instances. These diseases usually result from an acquired genetic injury to the DNA of a single cell. The numbers of stem cells in cord blood are often insufficient for the needs Figure 2: Source: Cancer Facts & Figures. Approximately 50 different drugs are now being used in the treatment of these diseases. freezing and storing of cord blood have provided another source of stem cells for transplantation. Research is being conducted to improve socalled “haploidentical” transplant. They are considered to be related cancers because they arise from cells with a common origin (the lymphohematopoietic stem cells) and with related functions. Hodgkin and non-Hodgkin lymphoma and myeloma are cancers that originate in a cell in the bone marrow or lymphatic tissues. An allogeneic transplant uses blood or marrow stem cells from a normal donor. which becomes abnormal (malignant) and multiplies continuously. decreased ability to fight infections and a predisposition to bleeding. However. for which a parent rather than a sibling could be the donor. The technique of harvesting stem cells from blood and cord blood has made transplantation available for more LEUKEMIA page 2 LYMPHOMA MYELOMA . a search of the National Marrow Donor Program registry of tissue-typed volunteers could be made for a matched unrelated donor. 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. (Numbers do not add up to 100% because of rounding. Patients with leukemia. usually in combinations of two or more drugs. Autologous transplantation uses the patient’s own marrow stem cells and is technically not transplantation since another person is not the donor. studies suggest that two matched cord donors may result in a higher success rate in larger adults. If a sibling is not available. Stem cells also circulate in large numbers in fetal blood and can be recovered from umbilical cord and placental blood after childbirth. 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. There are two major types of stem cell transplants: syngeneic and allogeneic. especially for children. Patients with acute lymphocytic leukemia (ALL). Syngeneic transplant describes the use of an identical twin as donor. is largely responsible for the dramatic improvement in managing leukemia and lymphoma. Such an approach would greatly lessen the proportion of children without a donor.) of larger adult patients. The blood or marrow stem cells are collected while the patient is in remission. American Cancer Society. The accumulation of malignant cells interferes with the body’s production of normal blood or immune cells and can result in severe anemia. some types of Hodgkin lymphoma. 2007. 2007.
Regular examinations may include screening for cancer recurrence or the development of secondary cancer or other late effects of treatment. In nonablative transplantation. marrow and immune system. identify recurrence of the disease and detect long-term or late effects. New Approaches to Treatment Several areas of research have resulted in new approaches to the treatment of leukemia. Development of New Drugs: In the past decade.childrensoncologygroup. 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. “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. two second-generation agents. Several organizations are working on evidence-based guidelines for adult blood cancer patients and their physicians that will standardize follow-up care and increase awareness about long-term and late effects. It works by blocking the oncogeneencoded protein product that instigates the transformation to a leukemic cell. lymphoma and myeloma. Biomarkers could be high levels of certain substances in the body such as antibodies or hormones. the donor’s cells take hold and the patient’s leukemia. Follow-Up Care Regular medical follow-up enables doctors to assess the full effect of therapy. as needed. as well as marrow. Cancers (http://www. In standard stem cell transplantation. Coordination between specialists and primary care physicians is essential to provide the best care possible. Over time. Cancer survivors should have physical examinations yearly or more often. Stem cells not only reside in the marrow but also circulate in the blood. and Young Adult LEUKEMIA LYMPHOMA MYELOMA page 3 .patients.org/). multi-disciplinary approach to monitoring and supporting 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. thereby allowing doctors to plan treatment accordingly. The protein is an enzyme in the family of tyrosine kinases. Adolescent. Most follow-up clinics specialize in pediatric cancer survivors. Imatinib mesylate (Gleevec®) is now the drug of choice in newly diagnosed patients with chronic myelogenous leukemia (CML). or genetic factors that can increase susceptibility to certain effects. “Ablation” referred to wipingout the recipient’s cancer. To ensure there will be enough blood stem cells for successful transplantation. Some treatment centers have follow-up clinics that provide a comprehensive. Identifying these biomarkers will allow researchers to develop tests that can predict what effects an individual is at risk of developing. lymphoma or myeloma can have an allogeneic transplant. lymphoma or myeloma is attacked and suppressed by donor lymphocytes that form from the donor stem cells. Because blood. few severe adverse effects on normal tissues and a very high response rate. several important new drugs and new uses for existing drugs have greatly improved cure rates or remission duration for some patients with leukemia. Gleevec offers several dramatic advantages to patients: oral administration. the recipient’s blood cell and immune system are preserved. donors of blood stem cells require special treatment to mobilize sufficient stem cells from marrow into their blood before cells are harvested. decreased side effects. frozen and stored and later transplanted in the patient. ablation of the recipient’s blood-cell forming and immune cells was the price that had to be paid to eradicate the leukemia. is a source of stem cells for transplantation. Although a minority of patients have developed resistance to the drug. lymphoma or myeloma and permit the donor’s cells to be accepted by the temporarily immunodeficient recipient. Follow-Up Guidelines: The Children’s Oncology Group has established Long-Term Follow-Up Guidelines for Survivors of Childhood. Cancer survivors should see their primary care physicians for general health examinations and an oncologist for follow-up care related to cancer. 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. This “graft versus leukemia or lymphoma effect” can suppress (cure) the malignancy and is a prolonged (indefinite) form of immunotherapy. these cells can be harvested from the blood of a donor. Blood and cord blood transplants differ from marrow transplants principally in the source of the cells collected for transplant. This still experimental approach greatly lessens the early toxicity of transplantation and has extended the age at which recipients with leukemia. making the procedure more tolerable. but some follow adult cancer survivors.
a less common type of chronic lymphocytic leukemia (CLL). Gleevec is not only a very important new agent in the treatment of CML. 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. perhaps 20 percent of cases also derive benefit. Alemtuzumab (Campath®) is a monoclonal antibody directed against the antigen CD52 found on T and B lymphocytes. Lenalidomide (Revlimid®). Arsenic trioxide also adds to the drugs available to treat this subtype of acute leukemia. 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. Other therapies in clinical research to treat MDS include arsenic trixoxide. Rituximab is an antibody directed at the target CD20 antigen on B-cell lymphoma cells. the most prevalent lymphoma subtype. but without this specific chromosome 5 abnormality. suppresses the progression of leukemia. however. farnesyl transferase inhibitors and reduced-intensity stem cell transplantation. but it can also induce remissions in some cases of acute leukemia. are entering clinical use and can overcome this resistance in some cases. cyclophosphamide. Early studies indicate the combination of arsenic trioxide and all-trans retinoic acid may be a further advance in the initiation of therapy. and enhances the specificity of treatment to minimize toxic effects on normal tissues. 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). Food and Drug Administration [FDA] in 2006) and nilotinib (in clinical trials). Cell surface antigens have been given a cluster designation (CD) followed by a number. Velcade is approved by the FDA for treating people with myeloma who have had at least one prior therapy. This drug is also being tested in clinical trials to treat adult acute leukemia and MDS. Cladribine induces long-term remissions in nearly 90 percent of patients treated at diagnosis for one week. PDGFR or KIT oncoproteins). In May 2006. immune cell administration and vaccine development. Rituximab has become an important agent to treat CD20-positive lymphocytic malignancies. such as follicular lymphoma. Immunotherapy: This is a treatment that uses immune cells or antibodies to fight the disease. 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. vincristine (Oncovin®) and prednisone–therapy for diffuse large B-cell lymphoma. Monoclonal antibodies have added to the arsenal of agents that are used for the treatment of patients with lymphoma and leukemia. approved by the FDA for all types of MDS. 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. Azacitidine (Vidaza®). Patients with more severe forms of MDS are very unlikely to respond to the agent. was approved by the FDA for newly diagnosed myeloma. Revlimid is approved by the FDA in combination with dexamethasone for the treatment of myeloma patients who have received at least one prior therapy. in combination with dexamethasone. 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®). chronic eosinophilic leukemia (formerly hypereosinophilic syndrome).dasatinib (Sprycel®)(approved by the U. thus rituximab is an anti-CD20 antibody. has improved dramatically with the introduction of cladribine. principally. Clofarabine (Clolar®). Three types of immunotherapy are being explored: antibody treatment. Some patients with moderately severe.S. reducing the need for transfusions in some patients. Indeed. although initially used in indolent lymphomas. doxorubicin (Adriamycin®). and Decitabine (Dacogen®). lymphoma or myeloma. Pentostatin is another effective drug that can be used in patients with hairy cell leukemia who do not respond to cladribine. 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. is being used to treat relapsed or refractory acute lymphocytic leukemia (ALL) in children who have received at least two prior therapies. Monoclonal Antibody Therapy: Monoclonal antibodies are laboratory-produced proteins that can be infused into an appropriate patient. The treatment of hairy cell leukemia. It is especially active against the lymphocytes in CLL. approved by the FDA in 2005. it has now become an important fifth drug in the R-CHOP–rituximab. thalidomide (Thalomid®). In patients with anemia. LEUKEMIA page 4 LYMPHOMA MYELOMA .
less responsive to therapy. This means that the vaccine induces an immune response against the cancer cells present in the patient. the patient’s immune cells would be treated in the laboratory to train them to attack the residual leukemia. new forms of cancer therapy may be developed. the infusion of the original marrow donor’s lymphocytes can re-induce remission. In some approaches. These are called conjugated monoclonal antibodies. In another approach.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. 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. Approaches to reversing multidrug resistance are under study. lymphoma and myeloma. LEUKEMIA LYMPHOMA MYELOMA page 5 . If the gene in the former case is an oncogene or the protein in the latter case is an oncoprotein. lymphoma or myeloma cells. The goal of several new agents being studied is to decrease resistance to an important chemotherapy drug used in leukemia. DNA vaccines that contain the DNA that encodes the specific antigen are being tested. These types of vaccines would be used in patients who have small amounts of residual blood cancer after chemotherapy or stem cell transplantation. 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. These cells are. Vaccines: Experimental treatment vaccines are now being studied to treat certain types of lymphoma. Examples of this treatment are the drugs ibritumomab (Zevalin®) and tositumomab and iodine I131 tositumomab (Bexxar®). Two new and potentially important approaches include a) the application of RNA interference. They deliver the toxic substance directly to the cancer cells. b) a modality that uses molecules of RNA to silence complementary (DNA) genes. Many cancer treatment vaccines under development are intended to induce antigen-specific antitumor immune responses. Monoclonal antibodies can also be linked to a radioactive isotope to target and kill specific cancer cells. myeloma and leukemia. In one approach. 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. or become. and aptamer treatment. In each case. 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. 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. a technique that prepares small molecules in the laboratory that have the ability to inactivate proteins that cause disease. cells are isolated in the laboratory and start making antibodies after insertion of the cancer antigen. is approved for older patients with AML who relapse after initial treatment. some vaccines are made from leukemic cells treated in test tubes to convert them to potent antigen-presenting cells. Vaccines are in clinical trials for types of acute and chronic leukemia. drugs are designed to interfere with the oncoprotein and prevent its effect on the cell. Paradoxically. gemtuzumab (Mylotarg®). In patients with CML who have relapsed after stem cell transplantation. Studies of vaccines used in patients with follicular or indolent lymphoma have demonstrated an immune response. In studies of CML. These agents can act on the gene (DNA) or on RNA to prevent the formation of the gene product or protein (oncoprotein) that is the direct cause of transforming the cell into a malignant type. The goal is to extend the duration of remission achieved by remissioninduction therapy of various types. An alternative strategy called molecular targeted drug development targets the oncoprotein. These drugs have been approved to treat relapsed B-cell non-Hodgkin lymphoma. 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. Patients with myeloma have also had remission re-induced by donor lymphocytes. 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.
579 21. The terms myelogenous or lymphocytic denote the cell type involved.) • The most common types of leukemia in adults are acute myelogenous leukemia (AML) and chronic lymphocytic leukemia (CLL).150 24. red blood cells and white blood cells.380 6. National Cancer Institute. Surveillance Research Program. NCI.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 5.720 44. Acute leukemia is a rapidly progressing disease that results in the accumulation of immature. Chronic leukemia progresses more slowly and allows greater numbers of more mature. 2007.410 4. males are expected to account for 56 percent of the new cases of leukemia. Table 3: Source: Cancer Facts & Figures 2007.S. Chronic leukemias account for 7 percent more of the cases than acute leukemias.501 50. The marrow often no longer produces enough normal platelets. Approximate U. • About 33 percent of cancers in children aged 0-14 years are leukemia • Most cases of chronic myelogenous leukemia (CML) occur in adults.140 6. Nearly 54 percent of the new cases of this disease will occur among children in 2007 (about 2. Prevalence of the Four Major Leukemias as of Jan. Only 2. based on the November 2006 SEER data submission. released April 2007. 2004 Type Chronic lymphocytic leukemia Chronic myelogenous leukemia Acute lymphocytic leukemia Acute myelogenous leukemia Prevalence* 95. *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. Prevalence database: U. Leukemia is divided into four categories: myelogenous or lymphocytic. It is characterized by the uncontrolled accumulation of blood cells. functional cells to be made.570 5.240 new cases of leukemia will be diagnosed in the United States this year. *Note: Incidence rates are the number of new cases in a given year not counting the preexisting cases.S. A shortage of platelets results in bruising and easy bleeding.350 2.340 13.Leukemia Leukemia is a malignant disease (cancer) of the bone marrow and blood.189 27. American Cancer Society.570 3.4 percent of leukemias in children aged 0-19 are CML. (About 40.800 children. 1. functionless cells in the marrow and blood. more than half of all cases occur after age 67. Leukemia is expected to strike more than 10 times as many adults as children in 2007. and End Results) Cancer Statistics Review 1975-2004. • Most cases of leukemia occur in older adults. each of which can be acute or chronic. a deficiency of red cells. In 2007. The four major types of leukemia are shown in Table 1. 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. Incidence by Gender Incidence rates* for all types of leukemia are higher among males than among females.060 2.440 Table 2: Sources: SEER (Surveillance. Anemia.000 population.800 Female 2. and SEER Program.200 15.960 7.790).570 19. aged 0-19. Estimated 29-Year L-D Prevalence Counts on 1/1/2004 by Duration.060 8. 2007.659 people in the United States are living with leukemia. New Cases An estimated 44. The incidence rates are usually presented as a specific number per 100. • The most common form of leukemia in children is acute lymphocytic leukemia (ALL). LEUKEMIA page 6 LYMPHOMA MYELOMA .440 adults compared with 3. develops in virtually all leukemia patients. DCCPS. Epidemiology. Statistical Research and Applications Branch. The lack of normal white cells impairs the body’s ability to fight infections.240 Male 3.000 2.
The diagnosis of leukemia requires specific blood tests. Although chronic exposure to benzene in the workplace and exposure to extraordinary doses of irradiation can be causes of the disease.Estimated Proportion of New Cases (%) in 2007 for Each Type of Leukemia Including Adults and Children 3.to 29-year olds. However. It is estimated that in 2007. Incidence by Age-Group Incidence rates by age differ for each of the leukemias. These cancers are most prevalent in the seventh.900 new cases of cancer diagnosed in African-Americans in 2007. leukemia rates are higher in Americans of European descent than among those of African descent.5 times that of ALL. The American Cancer Society estimates that there will be approximately 152. The leukemias represented 27 percent of all cancers occurring among children younger than 20 years from 2000-2004.619 with ALL. was 504 per 100. CML incidence also increases dramatically among people who are aged 60 and older. About 2. Among 15. Possible Causes of Leukemia Anyone can get leukemia. eighth and ninth decades of life. In 25.799 children under the age of 20 diagnosed with leukemia from 2001-2004. Hispanic children of all races under the age of 20 have the highest rates of leukemia. Leukemia is one of the top 15 most frequently occurring cancers in minority groups. The most common form of leukemia among children under 20 years of age is ALL. Leukemia strikes all ages and both sexes. Children.790 new cases of childhood ALL are expected to occur in 2007.800 children will be diagnosed with leukemia throughout the United States. Most children under 15 years of age with ALL are cured. In the 17 SEER regions of the United States.to 4-year-old children is more than nine times greater than the rate for young adults ages 20 to 24. 2007. Leukemia rates are substantially higher for Hispanic. 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). and AML incidence increases dramatically in people who are aged 60 and older. 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. including 3. 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. AML incidence was approximately 1.000 population.922 cases per year. These signs are not specific to leukemia and may be caused by other disorders. American Cancer Society. neither explains most cases. They do warrant medical evaluation. the incidence of AML slowly rose while that of ALL steadily decreased in the period from late adolescence to older adulthood. Figure 3: Source: Cancer Facts & Figures 2007. ALL incidence was approximately twice that of AML. white and Asian/Pacific islander children than for black children. from 2000-2004. LEUKEMIA LYMPHOMA MYELOMA page 7 . Adolescents and Young Adults. including the examination of the cells in blood or marrow. The cause of leukemia is not known. Some people with chronic leukemia may not have major symptoms and are diagnosed during a medical examination.to 19-year olds. CLL incidence increases dramatically among people who are aged 50 and older. American Indian/Alaskan natives. The incidence of ALL among 1. Leukemia incidence is highest among whites and lowest among American Indians/Alaskan natives. The incidence rate for all cancers among AfricanAmericans in the Seer (17 region). From 1975 to 2000. averaging about 189. Adults. there were 4.
9 25-29 1.4 percent for children under 5 • CLL: 74. 2007. the overall relative survival rate was nearly 50 percent.2 10.2 1. the five-year relative survival rate had jumped to 35 percent.2 15 13 11 9 7.1 for children under 15 • CML: 44.6 10-14 0. the five-year relative survival rates overall were: • ALL: 65. 2000-2004 25 23.000) 17 15.9 15-19 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. The relative survival rates differ by age of the patient at diagnosis. All Types Leukemia. a patient had a 14 percent chance of living five years. Relapse indicates return of the cancer cells and the return of other signs and symptoms of the disease. By 1975-1977.3 percent overall. National Cancer Institute.7 7 5 3 1 0 1.2 23 21 19 19. 2007. when compared to a person without leukemia.4 <1 0.4 percent Five-Year Relative Survival Rates for All Ages. During 1996-2003. In 1960-1963.9 20-24 0. Treatment of Leukemia The aim of treatment is to bring about a complete remission.7 percent overall. race and type of leukemia. 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. 90.5 21.1 Incidence (per 100. Thirty-two percent more males than females are living with leukemia. LEUKEMIA page 8 LYMPHOMA MYELOMA . For acute leukemia.3 3. The five-year relative survival rate has more than tripled in the past 47 years for patients with leukemia.Age-Specific Incidence Rates for Acute Myelogenous Leukemia (All Races).3 1. Survival Rates 40% 30% 20% 10% 0% 35% 1975-77 1978-80 1981-83 1984-86 1987-89 1990-92 1993-95 1996-2003 Years Figure 5: Sources: SEER (Surveillance. National Cancer Institute.6 2. a complete remission (no evidence of disease in the blood or marrow) that lasts five years after treatment often indicates cure.1 4. gender.4 5-9 0. 54.8 1-4 0. Complete remission means that there is no evidence of the disease and the patient returns to good health with normal blood and marrow cells. Treatment centers report increasing numbers of patients with leukemia who are in complete remission at least five years after diagnosis of their disease. and in 1996-2003. Epidemiology and End Results) Cancer Statistics Review 1975-2004. Epidemiology and End Results) Cancer Statistics Review 1975-2004.8 percent • AML: 20.
In 2007.320 Female 600 1. Deaths It is anticipated that approximately 21.990 deaths from AML and 490 deaths from CML. about 515 children under the age of 14 are expected to die from leukemia.990 490 6. Blood. There will be an estimated 4. 2007. deaths from leukemia are expected to be distributed in the following numbers: In 2007. leukemia causes more deaths than any other cancer among children and young adults under age 20. 1964:24:477-494. 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. There will be an estimated 8. National Cancer Institute.470 females. 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. Non-Hispanic whites diagnosed with leukemia over the age of 44 had the highest death rates during this period.470 Table 4: Source: Cancer Facts & Figures 2007. Unclassified forms of leukemia will account for 6. Sources: 1. Hispanics with leukemia who are under the age of 25 had the highest mortality rates from the disease between 1990 and 1999.970 250 2. SEER (Surveillance. 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. 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.790 Male 820 2. 2.390 additional deaths.500 deaths from CLL and 1. LEUKEMIA LYMPHOMA MYELOMA page 9 . Survival Rates 50% 40% 30% 20% 10% 0% 19641 197519772 197819802 198119832 198419862 198719892 199019922 199319952 199620032 3% Years Figure 6: The graph shows childhood ALL five-year relative survival rates have improved significantly over the past nearly 40 years. In 2007.020 240 3. 2007. Epidemiology and End Results). Zuelzer WW. American Cancer Society. unclassified forms of leukemia Total Overall 1. Despite this decline.680 12.940 3.500 8.420 deaths from ALL. in Children Under 15 Years of Age.Five-Year Relative Survival Rates for Acute Lymphocytic Leukemia. Cancer Statistics Review.420 4.320 males and 9.710 9.790 deaths in the United States will be attributed to leukemia in 2007: 12. leukemia will be the fifth most common cause of cancer deaths in men and the sixth most common in women.560 5. 1975-2004. Implications of long-term survivals in acute stem cell leukemia of childhood treated with composite cyclic therapy.
000 for females. 2007.470 34.190 cases of non-Hodgkin lymphoma). in general whites have higher incidence rates than blacks.9 per 100.8 percent. American Cancer Society. eventually crowding out healthy cells and creating tumors that enlarge the lymph nodes or other sites in the body.710 Total 8.380 Table 5: Source: Cancer Facts & Figures 2007.5 percent of all lymphomas diagnosed in 2007. New Cases of Lymphoma by Gender. 2007 Type Hodgkin lymphoma Non-Hodgkin lymphoma Total Male 4. The bacterium Helicobacter pylori is associated with the development of lymphoma in the stomach wall.000 for males and 38. Non-Hodgkin lymphoma is the fifth most common cancer in males and females in the United States. LEUKEMIA page 10 LYMPHOMA MYELOMA . These risk factors explain only a small proportion of cases. population who are living with lymphoma. incidence rates for non. or low. malignant cell found in Hodgkin lymphoma tissues). More than four percent of all cases of Hodgkin lymphoma diagnosed in 2007 will be in children under 15 years of age. New Cases About 71.190 cases of Hodgkin lymphoma and 63. 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.7 percent of all cases of non-Hodgkin lymphoma will be diagnosed in children under 15 years of age this year. After 50 to 54 years of age. The reasons for the development of non-Hodgkin lymphoma are not certain. The groups are often classified as indolent or aggressive. an average annual percentage increase of 2.9 per 100. Each histologic grouping is diagnosed and treated differently.Lymphoma Lymphoma is a general term for a group of cancers that originates in the lymphatic system.266 members of the U. rose by 84 percent from 1975 to 2004. Hodgkin Lymphoma Hodgkin lymphoma is a specialized form of lymphoma and will represent about 11. Lymphoma results when a lymphocyte (a type of white blood cell) undergoes a malignant change and begins to multiply.000 at ages 20 to 24 for males and 1.200 38. Hodgkin lymphoma has characteristics that distinguish it from all other cancers of the lymphatic system.380 Americans will be diagnosed with lymphoma in 2007 (8. 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. there are 138. The Epstein-Barr virus causes Burkitt’s lymphoma in Africa.190 71. Incidence rates for Hodgkin lymphoma tend to be higher among males than among females. Incidence by Gender Table 5 illustrates the breakdown of incidence of lymphoma by gender. they are 52. Persons infected with the human immunodeficiency virus (HIV) have a much higher risk of developing lymphoma.Hodgkin lymphoma are higher in Americans of European descent than among those of African descent. By ages 60 to 64. It is the sixth most common cause of cancer deaths in males and in females.670 Female 3.990 32.6 per 100. intermediate and high grade. Fifty-three percent of the blood cancers diagnosed are lymphomas.313 people living with Hodgkin lymphoma (active disease or in remission) and 405. Age-specific incidence rates of non-Hodgkin lymphoma are 2. The incidence of Hodgkin lymphoma is consistently lower than that of non-Hodgkin lymphoma.953 people living with nonHodgkin lymphoma for a total of 544. Immune suppression plays a role in some patients.190 63.S. while 0.3 per 100. and each has prognostic factors that categorize it as more or less favorable. Both Hodgkin and non-Hodgkin lymphomas are more common in males than in females.720 28. Living with Lymphoma In the United States in 2007. including the presence of an abnormal cell called the ReedSternberg cell (a large.000 for females. the difference was small. In 2004.
In children from 0 to 19 years of age. Treatment for non-Hodgkin lymphoma sometimes includes vaccines and other forms of immunotherapy. This represents a significant improvement in the rate of recovery. the highest incidence of non-Hodgkin lymphoma is in Asian/Pacific islanders. Non-Hodgkin lymphoma is the fifth most common cancer in Hispanics.1 per 100. comprising nearly 5 percent of all cancers diagnosed.4 cases per 100. Symptoms also often include fever.5 percent. Non-Hodgkin lymphoma is the ninth most common cause of cancer death in males and the seventh in females in the United States. persistent fatigue.660 from non-Hodgkin lymphoma.2 percent for Hodgkin lymphoma in people under 20 years of age.8 percent for all races in 1996-2003. 1. The most common early sign of other forms of lymphoma is also painless swelling of the lymph nodes – usually in the neck. Hispanics of all races have the second highest incidence rates of non-Hodgkin lymphoma after whites. Lymphomas (Hodgkin lymphoma. It has remained fairly constant since 1999. armpit. loss of appetite and bone pain. five-year relative survival for non-Hodgkin lymphoma is now 83. most children with nonHodgkin lymphoma did not live five years after diagnosis.9 percent). 3. In the United States. The rate increases more than 18 times to 45. It is rarest among American Indian/ Alaskan native children. and non-Hodgkin lymphoma. Treatment Hodgkin lymphoma is often treated with radiation and chemotherapy. Survival for Children Five-year relative survival is 95. Death rates have been declining for Hodgkin lymphoma patients since the mid-1970s. Signs and Symptoms Signs and symptoms of Hodgkin lymphoma include painless swelling of lymph nodes in the neck. Early stage.000 children in 2004. Deaths An estimated 19.000 people occur in 20. followed closely by Hispanic children of all races (24.to 24year-old individuals. Even in the mid-1970s. Survival for Adults Hodgkin lymphoma is now considered to be one of the most curable forms of cancer. Radiation. About 2. about 10. Incidence in Children The incidence of Hodgkin lymphoma among people under 20 years of age was 1. In children up to age 14 years. depending on the tumor size.8 percent) and neoplasms of the brain and other nervous tissue (17.000 persons at ages 80 to 84.5/1 million population). armpit or groin.000 by ages 60 to 64.070 from Hodgkin lymphoma).5 percent.400 children under the age of 15 will be diagnosed with cancer in 2007. groin or in the abdomen. The incidence in this group decreased almost steadily and significantly between 1975 and 1999. 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.0/1 million population). recurrent high fever.Among women.1 cases per 100. Five-year relative survival is now 95 percent for Hodgkin lymphoma in children aged 0 to 14 years. night sweats. lymphomas are most commonly diagnosed in whites (24. Incidence in Adults The incidence of non-Hodgkin lymphoma increases with age. indigestion and abdominal pain. cell type and location of the lymphoma. and is the eighth most common cause of cancer death in that group.730 persons will die from lymphoma in the United States in 2007 (18. Adolescents are more commonly diagnosed with Hodgkin lymphoma than young children. Hodgkin lymphoma incidence rates are higher in adolescents and young adults than in adults in their middle years. and more than 46-fold to 112.1 cases per 100. In children under 20 years of age. localized non-Hodgkin lymphoma is sometimes treated with radiation. troublesome itching and weight loss. excessive tiredness. sweating at night. the highest incidence of non-Hodgkin lymphoma is in non-Hispanic whites. 4. widespread disease requires chemotherapy or chemotherapy and/or monoclonal antibody therapy with radiation. 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 1996-2003.5 percent) are the third most common cancers in children. following leukemia (26. LEUKEMIA LYMPHOMA MYELOMA page 11 . From ages 15 to 19.
0 1. National Cancer Institute.730 Male 770 9.8 2.0 2. American Cancer Society.1 0.4 2. Table 6: Source: SEER (Surveillance.070 18.060 9. 2007.1 63. Age-Specific Incidence Rates for Non-Hodgkin Lymphoma.6 0.1 102.2 4.6 32.9 7.360 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.9 3.9 1. 2000-2004 6 Incidence (per 100. 2000-2004 110 100 90 80 Incidence (per 100.4 2.4 2. *<16 cases per time interval.Age-Specific Incidence Rates for Hodgkin Lymphoma.3 4.2 1.5 <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. LEUKEMIA page 12 LYMPHOMA MYELOMA .9 4.4 80. Epidemiology and End Results) Cancer Statistics Review 1975-2004. Epidemiology and End Results) Cancer Statistics Review 1975-2004.1 3.0 20 10 0 0. * <16 cases for time interval.600 10.0 3. Epidemiology and End Results) Cancer Statistics Review 1975-2004.000) 5 4 3 2 1 0 0. 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 1.0 45.1 3.4 4.8 112.0 100.4 2. 2007.000) 70 60 50 40 30 22.1 0. 2007.1 4.4 3.5 10.4 15.3 <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.370 Female 300 9.8 3.8 4.660 19. National Cancer Institute.0 0. 2007.
9 9. the patient’s own stem cells are used (autologous stem cell infusion). Recurrent infections may be an early sign of the disease. New Cases An estimated 19. 15-19. Treatment Chemotherapy for myeloma has led to sustained remissions in some patients.5 3. The onset of myeloma interferes with normal production of antibodies and makes myeloma patients susceptible to infections.900 (10. 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.1 0.790 deaths from myeloma are anticipated this year. Lenalidomide is approved by the FDA in combination with dexamethasone for the treatment of myeloma patients who have received at least one prior therapy. has been increasing.5/100. Living with Myeloma An estimated 60. National Cancer Institute.424 people in the United States are living with myeloma. It grows continuously and forms masses of plasma cells. 2007. • The median age at diagnosis for African-Americans is 67.8 14.000). LEUKEMIA LYMPHOMA MYELOMA page 13 .000) is 56 percent higher than for women (4. destroying normal bone tissue. median age at death from multiple myeloma is 74. Approximately 3 percent of all cancer-related deaths among AfricanAmericans in 2000-2004 were from myeloma. a type of white blood cell found in many tissues of the body. two or three drugs are used simultaneously. and it rarely occurs in people under age 45. especially in the marrow.1 Signs and Symptoms Often the first symptom of myeloma is bone pain caused by the effects of myeloma cells in the marrow.1/100. 1-4. At times. approximately double. Figure 9: Source: SEER (Surveillance. Usually.1 5. Deaths Approximately 10.3 0.0 37. The highest rates are found in black men 80 to 84 years of age and older (105/100.2/100. a B lymphocyte. Thalidomide is approved by the FDA for use in treating newly diagnosed myeloma.000) 40 30 20 10 0 0-24 0.5/100. • Americans of African descent have a much higher incidence rate. Patients may have anemia. 20-24). myeloma was the 10th most commonly diagnosed cancer among African-American men and women. The mortality rate from myeloma for people of African descent is more than double the rate for whites (7. Total survival for white males. 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. • The median age at diagnosis is 70. It is 71 for African-Americans.Myeloma Myeloma is a cancer of the plasma cells.960 men and 8.000) for all racial and ethnic groups. 2000-2004 Incidence (per 100. Bortezomib has been approved for treating myeloma in patients who have had at least two prior therapies. becomes malignant. Malignant plasma cells produce an abnormal protein called monoclonal immunoglobulin. especially.3/100. Sixty percent of those were diagnosed with the disease within the past four years.000) of myeloma than those of European descent (5.4 35.000 to 3. The U. tire more easily and feel weak.4 33. (11.940 women) new cases of myeloma will be diagnosed in the United States in 2007. but it is the most difficult blood cancer to treat successfully. In myeloma. SEER 17 areas (<1.1 28.1 21. the cell that forms plasma cells. Myeloma was the 10th most common cause of cancer deaths for women in 2000-2004. 5-9. Epidemiology and End Results) Cancer Statistics Review 1975-2004. • The incidence rate in men (7/100.000).7 1. Treatment is aimed at slowing progress of the disease. causing pain and crowding out normal blood cell production. From 2000 to 2004. 10-14.S. but primarily in the bone marrow. Age-Specific Incidence Rates for Myeloma. 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.000). Treatment may include intensive chemotherapy followed by stem cell transplantation to restore normal blood cell production. *<16 cases for each age interval. Fractures may occur as a result of the weakened bones.
) Table 9: Source: SEER (Surveillance.000 population and are age-adjusted to the 2000 population.0 Female 9.9 17. 2007. National Cancer Institute. Lymphoma and Myeloma The following tables showing incidence rates for leukemia. National Cancer Institute.5 Incidence Rates by Gender. for Whites.8 20.5 Table 8: Source: SEER (Surveillance.6 Female 9.6 2.7 5.2 2.3 19.3 2.4 4. 2007. (Based on SEER 17 areas.000 Population (2000-2004) Type Leukemia Non-Hodgkin lymphoma Hodgkin lymphoma Myeloma Overall 12.2 18.1 9.2 6.7 24.1 Table 10: Source: SEER (Surveillance. All Races. Incidence Rates by Gender.8 14. for Blacks.0 2.) Incidence Rates by Gender.4 11.Incidence Rates: Leukemia.0 23.1 2.2 14.000 Population (2000-2004) Type Leukemia Non-Hodgkin lymphoma Hodgkin lymphoma Myeloma Overall 10.6 4. per 100. per 100.9 2. (Based on SEER 17 areas.9 5. Epidemiology and End Results) Cancer Statistics Review 1975-2004. 2007.2 Male 16. the most recent available.0 7. per 100.1 11. Epidemiology and End Results) Cancer Statistics Review 1975-2004.3 Male 13.000 Population (2000-2004) Type Leukemia Non-Hodgkin lymphoma Hodgkin lymphoma Myeloma Overall 12.6 Male 16. Epidemiology and End Results) Cancer Statistics Review 1975-2004.3 2. Rates are per 100.5 16.1 3.2 3. Hodgkin and non-Hodgkin lymphoma and myeloma use figures from 2000-2004. (Based on SEER 17 areas. National Cancer Institute.) LEUKEMIA page 14 LYMPHOMA MYELOMA .0 Female 8.
2007 State Leukemia Non-Hodgkin Lymphoma Myeloma Hodgkin Lymphoma Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Dist.200 350 4.S.360 610 * 950 290 260 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** 350 * 400 240 2.150 290 270 70 * 1. LEUKEMIA LYMPHOMA MYELOMA page 15 .010 1. model (see below).610 670 610 110 60 3.540 1.390 1.S.070 Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Dist.140 380 140 1.510 500 60 70 900 380 220 160 280 430 100 370 460 730 310 170 400 70 110 120 80 650 120 1.300 470 90 100 750 430 300 220 290 310 110 320 420 660 350 170 500 80 110 130 90 600 120 1.030 570 * 610 210 360 1. They cannot be compared with previous years’ estimates to determine cancer incidence trends. ***Hodgkin lymphoma estimates are not available for 2007. **State estimates may not add up to U.070 110 1.050 140 140 * * 680 310 * 50 440 240 130 120 170 180 60 220 250 420 190 110 240 50 70 80 50 270 70 650 360 * 460 120 160 550 * 200 * 270 720 70 * 250 220 70 200 * 10.260 220 400 420 290 2. Table 12: Sources: Cancer Facts & Figures 2007.610 150 2.360 960 170 220 2. is described by Pickle et al. Mortality Public Use Data Tapes.. Note: These estimates are offered as a rough guide and should be interpreted with caution.790 330 * 320 200 1.370 100 * 430 380 130 350 * 19.140 60 260 80 410 1.080 600 7. 1969-2004.530 1.160 140 50 360 440 170 320 * 18.040 70 44. 2007 State Leukemia Non-Hodgkin Lymphoma Myeloma Hodgkin Lymphoma*** Estimated Deaths from Blood Cancers by Site. 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. American Cancer Society.630 540 80 120 990 510 310 230 320 330 100 390 490 770 400 210 460 80 150 160 100 680 120 1.160 1. Centers for Disease Control and Prevention.170 480 1.190 880 870 170 100 4.680 920 340 890 170 290 330 190 1. by State.250 1. National Center for Health Statistics.330 260 780 180 1. *Estimate is fewer than 50 cases. numbers are small and NCI and ACS are having difficulty fitting them into the Pickle et al.240 740 80 1. Numbers are rounded to the nearest 10.070 80 330 70 480 1. *Estimate is fewer than 50 cases. 2007.520 310 3.660 210 * 190 120 1.310 800 600 900 920 330 1.500 430 1. 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 2007.410 560 * 740 230 230 930 70 300 50 350 1.670 1.550 2.180 4.410 130 50 500 490 130 490 * 21. January/February 2007. 2006.S.370 250 280 2. CA A Cancer Journal for Clinicians. American Cancer Society. Note: These estimates are offered as a rough guide and should be interpreted with caution.080 1.880 240 250 50 50 1.030 910 620 420 680 680 250 630 1. 2007. Numbers are rounded to the nearest 10.560 770 890 3.130 300 80 900 960 300 1.830 240 230 60 * 1. total because of rounding and exclusion of estimates that are fewer than 50 cases. Used with permission.240 170 550 130 800 3. which is new for 2007. and additional data supplied by the American Cancer Society based on data from the U.710 570 500 2.190 290 * 280 200 1. **State estimates may not add up to U.Estimated New Cases of Blood Cancers by Site. Used with permission.300 110 63. and additional data supplied by the American Cancer Society. by State. The method of derivation.
no matter how long ago that diagnosis was.S. In this report. Bureau of the Census’ 2000 population data for that region. cancer or otherwise. state-by-state data for incidence of Hodgkin lymphoma are not available because these numbers are so small.S. estimates of cancer incidence. Thus..” as per SEER table I-21. January/February 2007. especially in looking at populations in which individuals have had more than one type of cancer. race or sex. The relative survival rate is a comparison of survival to a person who is free of the disease. 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.S. It considers deaths from all causes. his or her survival with leukemia may not be counted in leukemia prevalence statistics. 2007. LEUKEMIA page 16 LYMPHOMA MYELOMA . The specified date is 1/1/2004 for the prevalence estimates. race and ethnicity in various regions and region-specific health risks. The SEER (17 region) data cover only about 26 percent of the U. population. 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. Because of reporting delays from some of the SEER regions. survival and mortality have been revised. 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. if a person is initially diagnosed with melanoma and later develops leukemia. In some prevalence statistics. The data can be extrapolated for the entire United States by multiplying by the population ratio.” We are using the “29-year limited duration” prevalence figures. The data presented in this report are an extrapolation or estimate of the number of cases reported by the 17 Surveillance. 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. CA A Cancer Journal for Clinicians. Census. Definitions Incidence is the number of newly diagnosed cases for a specific cancer or for all cancers combined during a specific time period. in comparison to the 2002 SEER report. The description of the methods used was published in Pickle et al. prevalence numbers reported may vary depending upon the method used to determine them. but these figures do not take into account differences in geography. in some cases fewer than 17 SEER regions) and death data from the National Center for Health Statistics. Relative survival rate is an estimate of the percentage of patients who would be expected to survive the effects of the cancer. may be incomplete in some cases and the data may reflect adjustments that anticipate changes that will occur once the actual data are received. the American Cancer Society changed its method of estimating cancer incidence.Notes and Definitions Notes The United States does not have a nationwide reporting system or registry for blood cancers. When expressed as a rate. it is the number of new cases per standard unit of population during the time period. This year.S. These numbers are extrapolated to the entire 17 SEER regions by dividing the number of cancer cases or deaths in a specific region by the U. The American Cancer Society projects this year’s estimated cancer cases and deaths based on incidence rates for 1995 to 2003 from 41 states (approximately 86 percent of the estimated U. It includes new (incidence) and preexisting cases and is a function of both past incidence and survival. only the first diagnosed cancer counts. This change means that the 2007 incidence estimates are not comparable with previous estimates for determining cancer incidence trends. the data presented in the 2007 SEER report placed online on April 15. population) that belong to the National Program of Cancer Registries. Thus. Because of changes in the information — such as racial classification — gathered in the 2000 U. Epidemiology and End Results Program (SEER) regions (or. so the exact number of cases is not known. based on the “first invasive tumor for each cancer site diagnosed during the previous 29 years (1975-2003). Prevalence may be calculated in a number of different ways. Because of this change in method.) Prevalence is the estimated number of people alive on a certain date in a population who previously had a diagnosis of the disease. Incidence rates can be calculated based on a number of factors such as age. (Observed survival is the actual percentage of patients still alive at some specified time after diagnosis of cancer.
pp. pp. Jemal A. 065767. Zou Z. MD. pp. Barr R. 2006.TheOncologist. Bleyer A. “Highlights and Challenges.” Pickle LW. Ward E.gov/csr/1975_2004/ LEUKEMIA LYMPHOMA MYELOMA page 17 . 2007. Barr R. Bethesda. National Cancer Institute.Citations Source Citations Cancer Facts & Figures 2007.amcancersoc. and End Results (SEER) Program.cancer. January/February. Hachey M. 12. Ries LAG. pp. NIH Pub. Nachman J. Shu X-O. No. and End Results) Cancer Statistics Review. In Cancer Epidemiology in Older Adolescents and Young Adults 15 to 29 Years of Age. Atlanta: American Cancer Society. Ries LAG (eds). 1975-2004. p. Hao Y. January. “A New Method of Estimating United States and State-Level Cancer Incidence Counts for the Current Calendar Year. Stock W.” Bleyer A. Feuer EJ. 57. “Cancer Statistics. 174.” O’Leary M. CA A Cancer Journal for Clinicians Vol. Edwards BK (eds). Reichman ME. Howlander N. 20-37. based on November 2006 SEER data submission. 25-38. “Lymphomas and Reticuloendothelial Neoplasms. Mariotto A. Tiwari RC. Bleyer A. Howe HL. O’Leary M. O’Leary M.” Mattano L Jr. Atlanta: American Cancer Society. Horner MJ. MD. Krapcho M. No. 2006. Epidemiology. Miller BA. Including SEER Incidence and Survival: 1975-2000. 2006. Melbert D. http://www. 2007. Ries LAG (eds). http://caonline. 2007. Bleyer A. 06-5767. 30-42. and Multiple Primary Cancer Analyses from the Surveillance. Sheaffer J. NIH Pub. Bethesda.org/cgi/content/full/57/1/30. Epidemiology. Ross J. Barr R. O’Leary M.” Hayat MJ. National Cancer Institute. Cancer Facts & Figures for African Americans 2007-2008. In Cancer Epidemiology in Older Adolescents and Young Adults 15 to 29 Years of Age. Ries LAG (eds). SEER (Surveillance. No. Eisner MP. Feuer EJ. MD. 39-51. posted to the SEER Web site 2007. MD. Clegg L. National Cancer Institute. Cheson B.com/cgi/content/full/12/1/20. National Cancer Institute. Trends. NIH Pub. Including SEER Incidence and Survival: 1975-2000. Including SEER Incidence and Survival: 1975-2000. Edwards BK. The Oncologist Vol. 2007. 065767. Howlader N. Reichman M. Keller F. Bethesda. Barr R. Bethesda. In Cancer Epidemiology in Older Adolescents and Young Adults 15 to 29 Years of Age. “Leukemias. http://seer.
treatment or prevention of leukemia.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. We offer a wide variety of programs and services in support of our mission: Cure leukemia. The SCOR program brings together research teams working in complementary areas. The Specialized Center of Research (SCOR) in Leukemia. Translational Research • Scholars in Clinical Research are awarded $110. Each SCOR is funded up to $1.6 million annually on research. Awards up to $200. They are: 1) Career Development Program (CDP)-basic research.000 over three years. Translational Research Awards are made for an initial three-year period. lymphoma and myeloma should be encouraged worldwide. 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 . for a total of $600.000 over three years.25 million per year over a five-year period. 2) CDP-clinical research. The SCOR grants also support scientific core laboratories to provide access to innovative technology if required by the participating research programs. 3) Translational Research Program. Career Development Program The Career Development Program supports promising young scientists (Scholars. 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. Translational Research and the Specialized Center of Research (SCOR). Translational Research Program The Translational Research Program provides early-stage support for research on leukemia.000 over three years.000 a year for a total of $550. 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. or control of. 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. leukemia.000. diagnosis or prevention in the near term. The Society is a nonprofit organization that relies on the generosity of individual and corporate contributions to advance its mission. Awards go to those groups that best demonstrate the synergy that will occur from their close interaction. the Society has awarded more than $550 million in research grants.000 a year for a total of $150. • Special Fellows are awarded $60. the Society’s grant programs are among the most prestigious in the fields of blood cancers. • Special Fellows in Clinical Research are awarded $60.000 over five years. Research Research Grant Programs The Society’s research programs are based on the belief that all scientifically sound approaches toward a cure for. each focused on the discovery of new approaches to benefit patients or those at risk for developing leukemia. leading to better survival rates and prevention measures for patients.000 per year for three years. lymphoma.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 Grant Review Process Scientists and physician-scientists who are experts in the field of leukemia. and improve the quality of life of patients and their families. Thus. • Fellows are awarded $50. Hodgkin’s disease and myeloma. are granted each year.000 a year for a total of $550.000 a year for a total of $180. lymphoma and myeloma research comprise four review subcomittees.25 million. Since the first funding in 1954. Now supporting $61. Research grants are awarded in three program areas: Career Development. to a total cost of $6. lymphoma and myeloma. The participating scientists may be at different institutions or from any country.000 a year for a total of $180. lymphoma or myeloma. lymphoma and myeloma that is intended to advance treatment.
Patient Services The Society has a network of 68 chapters throughout the United States and Canada. It is continually being updated and expanded to support and promote the Society’s mission.m. treatments. A trained patient volunteer currently in remission phones the new patient to share information and support. where medical professionals share the latest research findings. podcasts and Webcast archives of these programs are available at www. families. brochures and videos through the IRC and local Society chapters. Patients. The Society funds several Focused Workshops each year on important topics relevant to hematological malignancies.LLS.org. 9 a. to 6 p. The IRC is a worldwide link to information and resources useful to patients.org. www. The Annual Research Symposium. Information Resource Center (IRC) The Society strives to be the world’s foremost source of information on leukemia. 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. treatment and prevention of leukemia. myeloma. Information specialists are oncology social workers and health educators who provide callers with current information on blood cancers. ET.org. Each year. information about our peer-to-peer program First Connection and other programs. They are available to talk one-onone.org. The Society’s Web Site The Society’s Web site. and encourages greater communication among patients.LLS. including support groups. each group provides information and support. The Society also hosts numerous teleconferences and Webcasts.org. The site features a comprehensive overview of blood cancers. As of June 30. from 10:00 a.” Chapter Programs: Family Support Groups: The Society has developed more than 360 Family Support Groups at 68 chapters. call (877) LLS-COPAY ( 557-2672) or email copay@LLS.org/copay. 2007 the Society will have 379 active grantees at 116 institutions in the United States and abroad. lymphoma. Professional Education The Society serves the continuing educational needs of the medical and research community through professional symposia offered throughout the year. Patients needing assistance may apply on the Society’s Web site. on the Society’s Web site. These offices conduct lifeenhancing patient services.org. the Translational Research Grant Progress Review Meeting and the SCOR Progress Review Meeting. instructions. Guidelines. audio. their families and healthcare professionals. Educational Materials An extensive collection of free educational materials are offered to patients and health professionals.LLS. Other meetings are held for the Society’s grantees.LLS. Much of the content of these materials is available to view and download at www.org. and applications for the Society’s three research programs may be obtained by visiting www. to 5:00 p. This support should advance the understanding. myelodysplastic syndromes (MDS) and other blood cancers. friends and healthcare professionals.LLS. Monday through Friday. The educational program offers varying formats to facilitate the exchange of information and ideas on the newest developments in cancer research and treatment. sponsored by the Society. Co-Pay Assistance Program Patients with AML. is held each December on the Friday immediately before the American Society of Hematology meeting. Teleconferences and Webcasts The Society sponsors more than 25 educational teleconferences and Webcasts each year on topics of interest to patients and caregivers. The user has the opportunity to create personalized pages with identified interests.LLS.LLS. Family Support Group locations. LEUKEMIA LYMPHOMA MYELOMA page 19 . clinical trials and offer guidance on coping.m. peer counseling and patient financial aid. lymphoma and myeloma.org or faxing to (914) 949-6691 or contacting the Research Department at (914) 949-5213.org or by or emailing researchprograms@LLS.m. the Society’s programs and services.m. Information on registration for these free events can be accessed at www. the Society distributes more than 1 million booklets. ET. Guided by two volunteer oncology health professionals.important projects to advance the Society’s mission. www. First Connection: This program links newly diagnosed patients to a peer volunteer who has experienced a similar diagnosis. families and professionals may call the IRC toll free at (800) 955-4572 in addition to corresponding by email at infocenter@LLS. and click “Live Help. www. serves a wide variety of education and information needs. You may also chat online with an information specialist. lymphoma. These include the Stohlman Scholar Symposium.
This program is made possible by the Lance Armstrong Foundation. the Society’s advocacy program has been a strong voice in Washington. The patient education program was funded at $18 million through 2007. treatments. 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. treatments. On the state level. Welcome Back: Facilitating the Return to School for Children with Cancer: A new addition to The Trish Greene Back to School Program.and long-term effects that children may experience after treatment. parents. Society volunteers and staff visit Capitol Hill regularly to lobby Congress in support of issues that impact research and patient care. how cancer drugs are developed and what the emerging treatment options are for leukemia.Patient Financial Aid Program: For more than 31 years. New insights. drugs and various treatments not covered by insurance. Working through chapters across the country. reimbursement of up to $500 per year helps cover the costs of transportation. CML Issues and Insights: A Nursing Education Program on Chronic Myelogenous Leukemia. To date. This Society program is being supported by Celgene Corporation and Millennium Pharmaceuticals. The Society has identified key issues that currently shape its advocacy agenda. this education program discusses possible emotional and cognitive short. This nursing education program provides an overview of CML. 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. Printed literature. LEUKEMIA page 20 LYMPHOMA MYELOMA . Advocacy Since 1994. risk factors. The Path to Progress: Clinical Trials in Blood Cancers: This program provides patients. This program is provided through an unrestricted educational grant from Millennium Pharmaceuticals. Department of Defense’s medical research program. unrestricted educational grant from Genentech BioOncology and Biogen Idec Inc. In 2002. including • Insurance coverage of patient-care costs in clinical trials • Ready access by all Americans to quality cancer care • Increased funding for the National Institutes of Health and National Cancer Institute (NCI) • Increased funding for blood cancer research at other federal institutions • Federal funding for patient education and support programs. Patient financial aid funds are subject to availability. DC. lymphoma and myeloma. patients and school personnel to assure youngsters a smooth transition from active treatment back to school. staging and classification of nonHodgkin lymphoma (NHL). It is supported by Amgen Oncology. That network now numbers more than 35. and offers numerous resources that can assist childhood cancer survivors to flourish in the school environment posttreatment.000 and has become a potent voice in public policy deliberations. 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. In 2001. the Society successfully lobbied Congress to institute a blood cancer research initiative as part of the U. diagnosis. representing to policy makers at all levels of government the healthcare quality concerns and medical research interests of patients and their families. This program is also accessible as a Webcast at www. that program has funded some $30 million in additional blood cancer research. videos and other materials to aid the process are available through all local chapters. Meet the Expert on Non-Hodgkin Lymphoma: This program presents basic information on terminology. emerging therapies and managing side effects and how to find emotional support when living with the illness. emerging therapies and side effects and addresses the unique challenges of nursing management of these patients. New Directions in Myeloma Therapy: This program presents an overview of myeloma.S. This program is being sponsored by an unrestricted education grant from Novartis Oncology. treatments and future directions for NHL are also discussed. Through the Patient Financial Aid Program.org and is being sponsored by a generous. families and healthcare professionals with a clear description of what clinical trials are. providing additional support for blood cancer patients and their families nationwide. The Trish Greene Back to School Program for Children with Cancer: This program is designed to increase communication among healthcare professionals. 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 Society has helped patients demonstrating a need for financial assistance cover a portion of their treatment costs.LLS.
This publication is designed to provide information in regard to the subject matter covered.Acknowledgements Additional data from SEER*Stat Databases at http://www. with the understanding that the Society is not engaged in rendering medical or other professional services.seer. and Rebecca Siegel.. NCI. provided ACS’s state-by-state statistics on myeloma and Hodgkin lymphoma. provided statistical assistance. for compilation of data for this publication. The Leukemia & Lymphoma Society extends special thanks to Myrna Watanabe.D. . It is distributed as a public service by The Leukemia & Lymphoma Society Inc. Ph.gov. Milton Eisner of SEER. of the American Cancer Society (ACS).cancer.
Suite 310 White Plains. New York 10605 Tel: 888.org Our mission: Cure leukemia.Home Office 1311 Mamaroneck Avenue. Hodgkin’s disease and myeloma.4572 www. corporate and foundation contributions to advance its mission.955. PS80 35M 6/07 . lymphoma.LLS Information Resource Center (IRC): 800.LLS. and improve the quality of life of patients and their families.HELP. The Society is a nonprofit organization that relies on the generosity of individual.
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