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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.
Myeloma: • • • • There are 60. lymphoma and myeloma in 2007. From 1975 to 2004. or nearly six people every hour. This year. 1998. someone dies from a blood cancer. Leukemia. the incidence of myeloma increased 8 percent. The data within Facts 2007-2008 reflect the most recent statistics available from SEER. in April 2007. Mortality from the disease increased 24 percent.953 either have or are in remission from non-Hodgkin lymphoma (NHL). www. • In general. an annual publication. 71.190 cases of Hodgkin.380 new cases of lymphoma will be diagnosed in the United States (8. *except acute myelogenous leukemia (AML) and other. *Myeloma Biology and Management.444. which becomes malignant and multiplies continuously. • These blood cancers will account for 9. 2007 and SEER 19731993.266 people living today with lymphoma. Deaths • Leukemia. • Every five minutes. 1996. Hodgkin and non-Hodgkin lymphoma. 138.790 people will die from myeloma.349 Americans are living with leukemia.730 people will die from lymphoma (1. nonacute myelogenous and monocytic leukemias Lymphoma: • There are 544. 44. 405. National Cancer Institute. LEUKEMIA LYMPHOMA MYELOMA page 1 .520 people in the United States will be diagnosed with leukemia.1975-1977 vs. 21. 19. 63.650 total cancer-related deaths. Hodgkin and non-Hodgkin lymphoma and myeloma will account for nearly 9. • Non-Hodgkin lymphoma is the fifth most common cancer in the United States. and myeloma. 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. the likelihood of dying from most leukemias*. 19. lymphoma and myeloma decreased from 1995 to 2004 (the last year data were available).790 people will die of leukemia. • Thirty-two percent more males are living with leukemia than females.4 percent of the 1.920 new cancer cases diagnosed in the United States this year. National Cancer Institute.Executive Summary Facts 2007-2008. These data were published online by SEER. This statistic represents 143 people each day.3 percent of the deaths from cancer in 2007 based on the 559.313 either have or are in remission from Hodgkin lymphoma. the National Cancer Institute’s Surveillance. Survival • An estimated 823.190 cases of non-Hodgkin). Cancer Statistics Review 1975-2004 (see Notes. • Leukemia causes more deaths than any other cancer among children and young adults under the age of 20. This abnormal accumulation interferes with the production of healthy blood cells. • This year. More males are diagnosed with leukemia and more males die of it than females. Oxford University Press. 18. 1975-2004. • In 2007. 2nd Edition. is a compilation of the most recent data on leukemia. 10.310 people in the United States this year. • Eighty-six percent of myeloma cases occur in people aged 55 and over. page 16). 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.gov.seer. someone is diagnosed with a blood cancer.240 people will be diagnosed with leukemia. Five-Year Relative Survival Rates 1960-1963 vs. and its age-adjusted incidence rose by nearly 84 percent from 1975 to 2004. lymphoma and myeloma will cause the deaths of an estimated 52.424 people living today with myeloma.660 from non-Hodgkin). • New cases of leukemia.900 people will be diagnosed with myeloma. • In 2007. Epidemiology and End Results Program. 1960-1963 1975-1977 1996-2003 Figure 1: Sources: SEER (Surveillance. • Every 10 minutes. • This year. Epidemiology and End Results) Cancer Statistics Review. This year.070 from Hodgkin.cancer. The next SEER Cancer Statistics Review is expected to be published online in April 2008.659 people in the United States who are either living with or are in remission from leukemia. lymphoma and myeloma. Highlights from the Report Include: New Cases • An estimated 135.
especially in young children. is largely responsible for the dramatic improvement in managing leukemia and lymphoma. The technique of harvesting stem cells from blood and cord blood has made transplantation available for more LEUKEMIA page 2 LYMPHOMA MYELOMA . 2007. The accumulation of malignant cells interferes with the body’s production of normal blood or immune cells and can result in severe anemia. usually in combinations of two or more drugs. 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. In special instances. The numbers of stem cells in cord blood are often insufficient for the needs Figure 2: Source: Cancer Facts & Figures. freezing and storing of cord blood have provided another source of stem cells for transplantation. Stem cells also circulate in large numbers in fetal blood and can be recovered from umbilical cord and placental blood after childbirth. 2007. 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 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. Hodgkin and non-Hodgkin lymphoma and myeloma are cancers that originate in a cell in the bone marrow or lymphatic tissues. If a sibling is not available. which becomes abnormal (malignant) and multiplies continuously. Such an approach would greatly lessen the proportion of children without a donor. decreased ability to fight infections and a predisposition to bleeding. usually a brother or sister with the same tissue type. studies suggest that two matched cord donors may result in a higher success rate in larger adults. Autologous transplantation uses the patient’s own marrow stem cells and is technically not transplantation since another person is not the donor. The harvesting. Blood and Marrow Stem Cell Transplantation: Stem cell transplantation from marrow was introduced approximately 45 years ago and is now standard therapy for selected patients with leukemia. These diseases usually result from an acquired genetic injury to the DNA of a single cell. for which a parent rather than a sibling could be the donor. myeloma and lymphoma are usually treated with chemotherapy. Approximately 50 different drugs are now being used in the treatment of these diseases. However. slightly mismatched cord stem cell donors may be used quite successfully. The technique is important. a search of the National Marrow Donor Program registry of tissue-typed volunteers could be made for a matched unrelated donor. The blood or marrow stem cells are collected while the patient is in remission.About the Diseases Leukemia. Patients with acute lymphocytic leukemia (ALL). (Numbers do not add up to 100% because of rounding. Research is being conducted to improve socalled “haploidentical” transplant. 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. An allogeneic transplant uses blood or marrow stem cells from a normal donor. 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. Syngeneic transplant describes the use of an identical twin as donor. especially for children. There are two major types of stem cell transplants: syngeneic and allogeneic. American Cancer Society. Patients with leukemia. lymphoma and myeloma. some types of Hodgkin lymphoma.) of larger adult patients.
the donor’s cells take hold and the patient’s leukemia. as needed. lymphoma and myeloma.patients. Stem cells not only reside in the marrow but also circulate in the blood. Follow-Up Guidelines: The Children’s Oncology Group has established Long-Term Follow-Up Guidelines for Survivors of Childhood. lymphoma or myeloma is attacked and suppressed by donor lymphocytes that form from the donor stem cells. two second-generation agents. but some follow adult cancer survivors. Adolescent. Development of New Drugs: In the past decade. 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. as well as marrow. 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. Because blood. To ensure there will be enough blood stem cells for successful transplantation. lymphoma or myeloma can have an allogeneic transplant. multi-disciplinary approach to monitoring and supporting cancer survivors. Cancers (http://www. Most follow-up clinics specialize in pediatric cancer survivors. It works by blocking the oncogeneencoded protein product that instigates the transformation to a leukemic cell. ablation of the recipient’s blood-cell forming and immune cells was the price that had to be paid to eradicate the leukemia. thereby allowing doctors to plan treatment accordingly. and Young Adult LEUKEMIA LYMPHOMA MYELOMA page 3 . is a source of stem cells for transplantation. New Approaches to Treatment Several areas of research have resulted in new approaches to the treatment of leukemia. In nonablative transplantation. The protein is an enzyme in the family of tyrosine kinases. Blood and cord blood transplants differ from marrow transplants principally in the source of the cells collected for transplant. several important new drugs and new uses for existing drugs have greatly improved cure rates or remission duration for some patients with leukemia. Biomarkers could be high levels of certain substances in the body such as antibodies or hormones. This “graft versus leukemia or lymphoma effect” can suppress (cure) the malignancy and is a prolonged (indefinite) form of immunotherapy. or genetic factors that can increase susceptibility to certain effects. Identifying these biomarkers will allow researchers to develop tests that can predict what effects an individual is at risk of developing. making the procedure more tolerable. Follow-Up Care Regular medical follow-up enables doctors to assess the full effect of therapy. Coordination between specialists and primary care physicians is essential to provide the best care possible. these cells can be harvested from the blood of a donor. few severe adverse effects on normal tissues and a very high response rate. “Ablation” referred to wipingout the recipient’s cancer. In standard stem cell transplantation. Cancer survivors should have physical examinations yearly or more often. the recipient’s blood cell and immune system are preserved. marrow and immune system. identify recurrence of the disease and detect long-term or late effects. donors of blood stem cells require special treatment to mobilize sufficient stem cells from marrow into their blood before cells are harvested. frozen and stored and later transplanted in the patient. “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. Over time. 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. Although a minority of patients have developed resistance to the drug.org/). decreased side effects. Some treatment centers have follow-up clinics that provide a comprehensive. Gleevec offers several dramatic advantages to patients: oral administration. Cancer survivors should see their primary care physicians for general health examinations and an oncologist for follow-up care related to cancer. Regular examinations may include screening for cancer recurrence or the development of secondary cancer or other late effects of treatment.childrensoncologygroup. 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 still experimental approach greatly lessens the early toxicity of transplantation and has extended the age at which recipients with leukemia. Imatinib mesylate (Gleevec®) is now the drug of choice in newly diagnosed patients with chronic myelogenous leukemia (CML). lymphoma or myeloma and permit the donor’s cells to be accepted by the temporarily immunodeficient recipient.
Food and Drug Administration [FDA] in 2006) and nilotinib (in clinical trials). cyclophosphamide.dasatinib (Sprycel®)(approved by the U. Cladribine induces long-term remissions in nearly 90 percent of patients treated at diagnosis for one week. 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. vincristine (Oncovin®) and prednisone–therapy for diffuse large B-cell lymphoma. although initially used in indolent lymphomas. 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. the most prevalent lymphoma subtype. Some patients with moderately severe. Clofarabine (Clolar®). doxorubicin (Adriamycin®). are entering clinical use and can overcome this resistance in some cases. Immunotherapy: This is a treatment that uses immune cells or antibodies to fight the disease. and Decitabine (Dacogen®).S. however. lymphoma or myeloma. thus rituximab is an anti-CD20 antibody. chronic eosinophilic leukemia (formerly hypereosinophilic syndrome). It is especially active against the lymphocytes in CLL. immune cell administration and vaccine development. Patients with more severe forms of MDS are very unlikely to respond to the agent. has improved dramatically with the introduction of cladribine. Monoclonal antibodies have added to the arsenal of agents that are used for the treatment of patients with lymphoma and leukemia. is being used to treat relapsed or refractory acute lymphocytic leukemia (ALL) in children who have received at least two prior therapies. 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. Monoclonal Antibody Therapy: Monoclonal antibodies are laboratory-produced proteins that can be infused into an appropriate patient. farnesyl transferase inhibitors and reduced-intensity stem cell transplantation. Alemtuzumab (Campath®) is a monoclonal antibody directed against the antigen CD52 found on T and B lymphocytes. 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). reducing the need for transfusions in some patients. approved by the FDA in 2005. Rituximab is an antibody directed at the target CD20 antigen on B-cell lymphoma cells. kill unhealthy bone marrow cells and may help the bone marrow function more normally in MDS patients. Early studies indicate the combination of arsenic trioxide and all-trans retinoic acid may be a further advance in the initiation of therapy. principally. The treatment of hairy cell leukemia. Cell surface antigens have been given a cluster designation (CD) followed by a number. Pentostatin is another effective drug that can be used in patients with hairy cell leukemia who do not respond to cladribine. Arsenic trioxide also adds to the drugs available to treat this subtype of acute leukemia. suppresses the progression of leukemia. perhaps 20 percent of cases also derive benefit. In patients with anemia. it has now become an important fifth drug in the R-CHOP–rituximab. in combination with dexamethasone. LEUKEMIA page 4 LYMPHOMA MYELOMA . such as follicular lymphoma. Azacitidine (Vidaza®). Rituximab has become an important agent to treat CD20-positive lymphocytic malignancies. In May 2006. was approved by the FDA for newly diagnosed myeloma. a thalidomide derivative. but it can also induce remissions in some cases of acute leukemia. and enhances the specificity of treatment to minimize toxic effects on normal tissues. Lenalidomide (Revlimid®). Velcade is approved by the FDA for treating people with myeloma who have had at least one prior therapy. approved by the FDA for all types of MDS. Other therapies in clinical research to treat MDS include arsenic trixoxide. Revlimid is approved by the FDA in combination with dexamethasone for the treatment of myeloma patients who have received at least one prior therapy. symptomatic anemia have improvement in hemoglobin levels with this agent. 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. Indeed. Gleevec is not only a very important new agent in the treatment of CML. This drug is also being tested in clinical trials to treat adult acute leukemia and MDS. but without this specific chromosome 5 abnormality. PDGFR or KIT oncoproteins). thalidomide (Thalomid®). 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®). a less common type of chronic lymphocytic leukemia (CLL). Three types of immunotherapy are being explored: antibody treatment.
new forms of cancer therapy may be developed. cells are isolated in the laboratory and start making antibodies after insertion of the cancer antigen. These types of vaccines would be used in patients who have small amounts of residual blood cancer after chemotherapy or stem cell transplantation. gemtuzumab (Mylotarg®). Examples of this treatment are the drugs ibritumomab (Zevalin®) and tositumomab and iodine I131 tositumomab (Bexxar®). 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. and aptamer treatment. These cells are.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 are made from leukemic cells treated in test tubes to convert them to potent antigen-presenting cells. These are called conjugated monoclonal antibodies. In one approach. These agents can act on the gene (DNA) or on RNA to prevent the formation of the gene product or protein (oncoprotein) that is the direct cause of transforming the cell into a malignant type. These 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. DNA vaccines that contain the DNA that encodes the specific antigen are being tested. b) a modality that uses molecules of RNA to silence complementary (DNA) genes. An alternative strategy called molecular targeted drug development targets the oncoprotein. These drugs have been approved to treat relapsed B-cell non-Hodgkin lymphoma. In patients with CML who have relapsed after stem cell transplantation. LEUKEMIA LYMPHOMA MYELOMA page 5 . 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. Paradoxically. drugs are designed to interfere with the oncoprotein and prevent its effect on the cell. or become. Studies of vaccines used in patients with follicular or indolent lymphoma have demonstrated an immune response. Approaches to reversing multidrug resistance are under study. Monoclonal antibodies can also be linked to a radioactive isotope to target and kill specific cancer cells. This drug. Reversal of Multidrug Resistance: The malignant cells of patients have mechanisms that may allow them to escape the damaging effects of chemotherapy agents. If the gene in the former case is an oncogene or the protein in the latter case is an oncoprotein. lymphoma or myeloma cells. is approved for older patients with AML who relapse after initial treatment. lymphoma and myeloma. 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. the infusion of the original marrow donor’s lymphocytes can re-induce remission. This means that the vaccine induces an immune response against the cancer cells present in the patient. The goal of several new agents being studied is to decrease resistance to an important chemotherapy drug used in leukemia. Some vaccines contain antigens or parts of antigens purified from cancer cells obtained from the patient or from the same type of cancer cells but obtained from another patient. Many cancer treatment vaccines under development are intended to induce antigen-specific antitumor immune responses. Patients with myeloma have also had remission re-induced by donor lymphocytes. In each case. Vaccines are in clinical trials for types of acute and chronic leukemia. 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 studies of CML. Vaccines: Experimental treatment vaccines are now being studied to treat certain types of lymphoma. a technique that prepares small molecules in the laboratory that have the ability to inactivate proteins that cause disease. the patient’s immune cells would be treated in the laboratory to train them to attack the residual leukemia. They deliver the toxic substance directly to the cancer cells. In some approaches. The goal is to extend the duration of remission achieved by remissioninduction therapy of various types. Two new and potentially important approaches include a) the application of RNA interference. In another approach. gene therapy researchers are trying to modify an oncogene (BCR-ABL) that produces a protein that stimulates malignant cell growth. myeloma and leukemia. less responsive to therapy.
each of which can be acute or chronic. aged 0-19. Nearly 54 percent of the new cases of this disease will occur among children in 2007 (about 2. Leukemia is divided into four categories: myelogenous or lymphocytic.240 Male 3. Leukemia is expected to strike more than 10 times as many adults as children in 2007.440 Table 2: Sources: SEER (Surveillance. Approximate U.570 5. 2007.960 7. The incidence rates are usually presented as a specific number per 100.060 8. • About 33 percent of cancers in children aged 0-14 years are leukemia • Most cases of chronic myelogenous leukemia (CML) occur in adults.410 4.000 2. Prevalence of the Four Major Leukemias as of Jan. red blood cells and white blood cells. functional cells to be made. The lack of normal white cells impairs the body’s ability to fight infections. and End Results) Cancer Statistics Review 1975-2004.289 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.) • The most common types of leukemia in adults are acute myelogenous leukemia (AML) and chronic lymphocytic leukemia (CLL). Epidemiology. 2004 Type Chronic lymphocytic leukemia Chronic myelogenous leukemia Acute lymphocytic leukemia Acute myelogenous leukemia Prevalence* 95.140 6. Acute leukemia is a rapidly progressing disease that results in the accumulation of immature. Chronic leukemias account for 7 percent more of the cases than acute leukemias.501 50.000 population. more than half of all cases occur after age 67. • Most cases of leukemia occur in older adults.240 new cases of leukemia will be diagnosed in the United States this year.S. The terms myelogenous or lymphocytic denote the cell type involved. Chronic leukemia progresses more slowly and allows greater numbers of more mature. National Cancer Institute.4 percent of leukemias in children aged 0-19 are CML. The four major types of leukemia are shown in Table 1.800 children. 1. 2007. Statistical Research and Applications Branch. based on the November 2006 SEER data submission. Anemia.150 24. Incidence by Gender Incidence rates* for all types of leukemia are higher among males than among females. DCCPS. a deficiency of red cells.Leukemia Leukemia is a malignant disease (cancer) of the bone marrow and blood.659 people in the United States are living with leukemia.790).189 27. Table 3: Source: Cancer Facts & Figures 2007. and SEER Program. *Note: Incidence rates are the number of new cases in a given year not counting the preexisting cases.200 15. Prevalence database: U.579 21. • The most common form of leukemia in children is acute lymphocytic leukemia (ALL).440 adults compared with 3. males are expected to account for 56 percent of the new cases of leukemia.340 13.800 Female 2. *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.720 44. (About 40. released April 2007.570 3. In 2007. Surveillance Research Program. Estimated 29-Year L-D Prevalence Counts on 1/1/2004 by Duration. Only 2.060 2. The marrow often no longer produces enough normal platelets.350 2. 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. New Cases An estimated 44.380 6. American Cancer Society. NCI.S. functionless cells in the marrow and blood. A shortage of platelets results in bruising and easy bleeding. LEUKEMIA page 6 LYMPHOMA MYELOMA .570 19. develops in virtually all leukemia patients. It is characterized by the uncontrolled accumulation of blood cells.
000 population. Children. Although chronic exposure to benzene in the workplace and exposure to extraordinary doses of irradiation can be causes of the disease. Leukemia rates are substantially higher for Hispanic. Leukemia strikes all ages and both sexes. They do warrant medical evaluation.to 29-year olds. However. neither explains most cases. was 504 per 100. Hispanic children of all races under the age of 20 have the highest rates of leukemia. The leukemias represented 27 percent of all cancers occurring among children younger than 20 years from 2000-2004. there were 4. The diagnosis of leukemia requires specific blood tests. The most common form of leukemia among children under 20 years of age is ALL. Leukemia is one of the top 15 most frequently occurring cancers in minority groups. the incidence of AML slowly rose while that of ALL steadily decreased in the period from late adolescence to older adulthood. About 2. 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. Possible Causes of Leukemia Anyone can get leukemia.900 new cases of cancer diagnosed in African-Americans in 2007. CLL incidence increases dramatically among people who are aged 50 and older.922 cases per year. LEUKEMIA LYMPHOMA MYELOMA page 7 . Figure 3: Source: Cancer Facts & Figures 2007. Adults. Most children under 15 years of age with ALL are cured. 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. These cancers are most prevalent in the seventh. CML incidence also increases dramatically among people who are aged 60 and older. The incidence of ALL among 1.5 times that of ALL. American Indian/Alaskan natives.800 children will be diagnosed with leukemia throughout the United States. 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. ALL incidence was approximately twice that of AML. Among 15. 2007. American Cancer Society. 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).to 4-year-old children is more than nine times greater than the rate for young adults ages 20 to 24. The American Cancer Society estimates that there will be approximately 152. averaging about 189.790 new cases of childhood ALL are expected to occur in 2007. These signs are not specific to leukemia and may be caused by other disorders. Leukemia incidence is highest among whites and lowest among American Indians/Alaskan natives. including the examination of the cells in blood or marrow.619 with ALL. Some people with chronic leukemia may not have major symptoms and are diagnosed during a medical examination. It is estimated that in 2007.to 19-year olds. and AML incidence increases dramatically in people who are aged 60 and older. AML incidence was approximately 1. From 1975 to 2000. The cause of leukemia is not known.Estimated Proportion of New Cases (%) in 2007 for Each Type of Leukemia Including Adults and Children 3. from 2000-2004. including 3. eighth and ninth decades of life. In the 17 SEER regions of the United States. leukemia rates are higher in Americans of European descent than among those of African descent. Incidence by Age-Group Incidence rates by age differ for each of the leukemias. Adolescents and Young Adults. white and Asian/Pacific islander children than for black children. In 25.
3 3. 54. During 1996-2003.3 percent overall.Age-Specific Incidence Rates for Acute Myelogenous Leukemia (All Races). The five-year relative survival rate has more than tripled in the past 47 years for patients with leukemia. In 1960-1963.1 Incidence (per 100. the five-year relative survival rates overall were: • ALL: 65.4 <1 0.8 1-4 0.9 20-24 0.1 4. Relapse indicates return of the cancer cells and the return of other signs and symptoms of the disease.4 5-9 0. 2000-2004 25 23.4 percent Five-Year Relative Survival Rates for All Ages. Thirty-two percent more males than females are living with leukemia.7 7 5 3 1 0 1.000) 17 15.2 10.9 25-29 1. 2007.1 for children under 15 • CML: 44.2 1. For acute leukemia. Complete remission means that there is no evidence of the disease and the patient returns to good health with normal blood and marrow cells.5 21.4 percent for children under 5 • CLL: 74.8 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. National Cancer Institute.8 percent • AML: 20. and in 1996-2003. Epidemiology and End Results) Cancer Statistics Review 1975-2004.2 23 21 19 19.6 10-14 0. National Cancer Institute. By 1975-1977. All Types Leukemia. Epidemiology and End Results) Cancer Statistics Review 1975-2004. 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. gender. when compared to a person without leukemia. the overall relative survival rate was nearly 50 percent. 2007.9 15-19 0. Treatment centers report increasing numbers of patients with leukemia who are in complete remission at least five years after diagnosis of their disease.3 1. a complete remission (no evidence of disease in the blood or marrow) that lasts five years after treatment often indicates cure. The relative survival rates differ by age of the patient at diagnosis. race and type of leukemia. Treatment of Leukemia The aim of treatment is to bring about a complete remission.6 2. the five-year relative survival rate had jumped to 35 percent. LEUKEMIA page 8 LYMPHOMA MYELOMA . a patient had a 14 percent chance of living five years.7 percent overall. 90. 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.2 15 13 11 9 7.
Hispanics with leukemia who are under the age of 25 had the highest mortality rates from the disease between 1990 and 1999. Blood. 1964:24:477-494. Deaths It is anticipated that approximately 21. There will be an estimated 8. Unclassified forms of leukemia will account for 6.560 5. 1975-2004.680 12.710 9. Cancer Statistics Review. African-Americans who were diagnosed with leukemia between the ages of 25 and 44 had the highest death rates from the disease during this period. 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. unclassified forms of leukemia Total Overall 1.420 4. In 2007.470 Table 4: Source: Cancer Facts & Figures 2007.500 deaths from CLL and 1. Implications of long-term survivals in acute stem cell leukemia of childhood treated with composite cyclic therapy.790 deaths in the United States will be attributed to leukemia in 2007: 12. deaths from leukemia are expected to be distributed in the following numbers: In 2007. The leukemia death rate for children from 0 to 14 years in the United States has declined about 70 percent over the past three decades. Sources: 1. Despite this decline.390 additional deaths.320 Female 600 1.320 males and 9. There will be an estimated 4.990 deaths from AML and 490 deaths from CML.Five-Year Relative Survival Rates for Acute Lymphocytic Leukemia.390 21. in Children Under 15 Years of Age. In 2007. Non-Hispanic whites diagnosed with leukemia over the age of 44 had the highest death rates during this period. Epidemiology and End Results). American Cancer Society.790 Male 820 2.940 3. 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.420 deaths from ALL. 2007. SEER (Surveillance. about 515 children under the age of 14 are expected to die from leukemia. National Cancer Institute. 2007. Zuelzer WW. leukemia will be the fifth most common cause of cancer deaths in men and the sixth most common in women. 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. LEUKEMIA LYMPHOMA MYELOMA page 9 . 2.020 240 3. leukemia causes more deaths than any other cancer among children and young adults under age 20.470 females.500 8.990 490 6.970 250 2.
The Epstein-Barr virus causes Burkitt’s lymphoma in Africa.470 34. they are 52. American Cancer Society. eventually crowding out healthy cells and creating tumors that enlarge the lymph nodes or other sites in the body. incidence rates for non.8 percent. an average annual percentage increase of 2. 2007. and each has prognostic factors that categorize it as more or less favorable. Lymphoma results when a lymphocyte (a type of white blood cell) undergoes a malignant change and begins to multiply. Living with Lymphoma In the United States in 2007. By ages 60 to 64. Age-specific incidence rates of non-Hodgkin lymphoma are 2. in general whites have higher incidence rates than blacks. 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 are higher in Americans of European descent than among those of African descent.000 for females. Hodgkin Lymphoma Hodgkin lymphoma is a specialized form of lymphoma and will represent about 11.000 for males and 38.190 cases of Hodgkin lymphoma and 63. The reasons for the development of non-Hodgkin lymphoma are not certain.313 people living with Hodgkin lymphoma (active disease or in remission) and 405. intermediate and high grade. Immune suppression plays a role in some patients. or low. there are 138.380 Americans will be diagnosed with lymphoma in 2007 (8. New Cases of Lymphoma by Gender. Fifty-three percent of the blood cancers diagnosed are lymphomas.200 38.7 percent of all cases of non-Hodgkin lymphoma will be diagnosed in children under 15 years of age this year. The groups are often classified as indolent or aggressive.3 per 100.380 Table 5: Source: Cancer Facts & Figures 2007.5 percent of all lymphomas diagnosed in 2007. More than four percent of all cases of Hodgkin lymphoma diagnosed in 2007 will be in children under 15 years of age.190 63. Incidence rates for Hodgkin lymphoma tend to be higher among males than among females.6 per 100. These risk factors explain only a small proportion of cases. 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. the difference was small. The incidence of Hodgkin lymphoma is consistently lower than that of non-Hodgkin lymphoma.9 per 100.S.000 at ages 20 to 24 for males and 1. rose by 84 percent from 1975 to 2004. After 50 to 54 years of age. including the presence of an abnormal cell called the ReedSternberg cell (a large. LEUKEMIA page 10 LYMPHOMA MYELOMA .953 people living with nonHodgkin lymphoma for a total of 544. Non-Hodgkin lymphoma is the fifth most common cancer in males and females in the United States. Both Hodgkin and non-Hodgkin lymphomas are more common in males than in females. It is the sixth most common cause of cancer deaths in males and in females. while 0. In 2004. Incidence by Gender Table 5 illustrates the breakdown of incidence of lymphoma by gender. population who are living with lymphoma. Hodgkin lymphoma has characteristics that distinguish it from all other cancers of the lymphatic system.710 Total 8. Each histologic grouping is diagnosed and treated differently.000 for females. The bacterium Helicobacter pylori is associated with the development of lymphoma in the stomach wall.670 Female 3. New Cases About 71.9 per 100.990 32.190 71. 2007 Type Hodgkin lymphoma Non-Hodgkin lymphoma Total Male 4. malignant cell found in Hodgkin lymphoma tissues).Lymphoma Lymphoma is a general term for a group of cancers that originates in the lymphatic system. Persons infected with the human immunodeficiency virus (HIV) have a much higher risk of developing lymphoma.720 28.190 cases of non-Hodgkin lymphoma).266 members of the U.
about 10. Hodgkin lymphoma incidence rates are higher in adolescents and young adults than in adults in their middle years.8 percent) and neoplasms of the brain and other nervous tissue (17. sweating at night. Adolescents are more commonly diagnosed with Hodgkin lymphoma than young children.1 cases per 100. widespread disease requires chemotherapy or chemotherapy and/or monoclonal antibody therapy with radiation. recurrent high fever.000 by ages 60 to 64. loss of appetite and bone pain. persistent fatigue. and is the eighth most common cause of cancer death in that group. the highest incidence of non-Hodgkin lymphoma is in non-Hispanic whites.9 percent). The incidence in this group decreased almost steadily and significantly between 1975 and 1999. Radiation.2 percent for Hodgkin lymphoma in people under 20 years of age. Incidence in Adults The incidence of non-Hodgkin lymphoma increases with age. Non-Hodgkin lymphoma is the ninth most common cause of cancer death in males and the seventh in females in the United States. chemotherapy or both may result in cures for most patients with Hodgkin lymphoma. cell type and location of the lymphoma. It is rarest among American Indian/ Alaskan native children. 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. In children up to age 14 years.1 cases per 100. In children under 20 years of age.5/1 million population). Incidence in Children The incidence of Hodgkin lymphoma among people under 20 years of age was 1. Survival for Children Five-year relative survival is 95. The most common early sign of other forms of lymphoma is also painless swelling of the lymph nodes – usually in the neck.5 percent. comprising nearly 5 percent of all cancers diagnosed. most children with nonHodgkin lymphoma did not live five years after diagnosis. following leukemia (26.1 per 100. Non-Hodgkin lymphoma is the fifth most common cancer in Hispanics. followed closely by Hispanic children of all races (24. indigestion and abdominal pain.8 percent for all races in 1996-2003.0/1 million population). and more than 46-fold to 112.000 people occur in 20. localized non-Hodgkin lymphoma is sometimes treated with radiation. 1. five-year relative survival for non-Hodgkin lymphoma is now 83.730 persons will die from lymphoma in the United States in 2007 (18. Early stage. night sweats.5 percent. It has remained fairly constant since 1999.5 percent) are the third most common cancers in children.000 children in 2004. and non-Hodgkin lymphoma.Among women. Signs and Symptoms Signs and symptoms of Hodgkin lymphoma include painless swelling of lymph nodes in the neck. The five-year relative survival rate for non-Hodgkin lymphoma patients has risen from 31 percent in whites in 1960-1963 to 63. This represents a significant improvement in the rate of recovery. excessive tiredness. Death rates have been declining for Hodgkin lymphoma patients since the mid-1970s. 4.660 from non-Hodgkin lymphoma. Even in the mid-1970s. Treatment for non-Hodgkin lymphoma sometimes includes vaccines and other forms of immunotherapy. Five-year relative survival is now 95 percent for Hodgkin lymphoma in children aged 0 to 14 years. armpit or groin. Deaths An estimated 19. From ages 15 to 19. lymphomas are most commonly diagnosed in whites (24.000 persons at ages 80 to 84. Lymphomas (Hodgkin lymphoma. depending on the tumor size. troublesome itching and weight loss. About 2. In the United States.to 24year-old individuals. The rate increases more than 18 times to 45. Survival for Adults Hodgkin lymphoma is now considered to be one of the most curable forms of cancer. Symptoms also often include fever. Hispanics of all races have the second highest incidence rates of non-Hodgkin lymphoma after whites. LEUKEMIA LYMPHOMA MYELOMA page 11 . 3.070 from Hodgkin lymphoma). Treatment Hodgkin lymphoma is often treated with radiation and chemotherapy. groin or in the abdomen. In children from 0 to 19 years of age.400 children under the age of 15 will be diagnosed with cancer in 2007. the highest incidence of non-Hodgkin lymphoma is in Asian/Pacific islanders. armpit.4 cases per 100.
4 2.0 100.Age-Specific Incidence Rates for Hodgkin Lymphoma.0 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. *<16 cases per time interval. Epidemiology and End Results) Cancer Statistics Review 1975-2004.4 15.1 0.0 2.9 7.2 1. Epidemiology and End Results) Cancer Statistics Review 1975-2004.6 0.5 10.060 9.600 10. National Cancer Institute.730 Male 770 9.9 3.660 19.370 Female 300 9.1 0.1 4.070 18. Epidemiology and End Results) Cancer Statistics Review 1975-2004.8 3. 2007.3 4. 2007.2 4. 2007. 2007.8 112.8 4.4 3. LEUKEMIA page 12 LYMPHOMA MYELOMA .0 3.1 3.4 2.1 3.0 45.9 4.360 Non-Hodgkin Lymphoma All races Whites African-Americans 1975-77 48% 48% 49% 1981-83 1990-92 1996-2003 53% 53% 50% 52% 53% 42% 64% 65% 56% Table 7: Source: Cancer Facts & Figures 2007. 2000-2004 6 Incidence (per 100.000) 70 60 50 40 30 22.4 80. * <16 cases for time interval.9 1.6 32.1 63.4 2.1 102. National Cancer Institute. 2000-2004 110 100 90 80 Incidence (per 100.3 <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.0 20 10 0 0. Age-Specific Incidence Rates for Non-Hodgkin Lymphoma.4 2.5 <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. American Cancer Society.8 2.000) 5 4 3 2 1 0 0.4 4. Table 6: Source: SEER (Surveillance. National Cancer Institute.
9 9. 2007. LEUKEMIA LYMPHOMA MYELOMA page 13 .000).960 men and 8. Deaths Approximately 10. SEER 17 areas (<1. New Cases An estimated 19. The U. (11.S.000) is 56 percent higher than for women (4. Figure 9: Source: SEER (Surveillance. the cell that forms plasma cells. Approximately 3 percent of all cancer-related deaths among AfricanAmericans in 2000-2004 were from myeloma.7 1.000 to 3. but it is the most difficult blood cancer to treat successfully. Fractures may occur as a result of the weakened bones.000).000) for all racial and ethnic groups.000) of myeloma than those of European descent (5. a B lymphocyte. a type of white blood cell found in many tissues of the body. Patients may have anemia. It grows continuously and forms masses of plasma cells.790 deaths from myeloma are anticipated this year.1/100.2/100.5/100. but primarily in the bone marrow.1 5. • Americans of African descent have a much higher incidence rate.000) 40 30 20 10 0 0-24 0. median age at death from multiple myeloma is 74. Recurrent infections may be an early sign of the disease.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. approximately double. Sixty percent of those were diagnosed with the disease within the past four years. Lenalidomide is approved by the FDA in combination with dexamethasone for the treatment of myeloma patients who have received at least one prior therapy. two or three drugs are used simultaneously.3 0. The mortality rate from myeloma for people of African descent is more than double the rate for whites (7. especially in the marrow.Myeloma Myeloma is a cancer of the plasma cells. 2000-2004 Incidence (per 100.1 28.8 14.1 Signs and Symptoms Often the first symptom of myeloma is bone pain caused by the effects of myeloma cells in the marrow. In myeloma. • The incidence rate in men (7/100. From 2000 to 2004. Treatment Chemotherapy for myeloma has led to sustained remissions in some patients. myeloma was the 10th most commonly diagnosed cancer among African-American men and women. has been increasing. becomes malignant. 5-9. At times. destroying normal bone tissue. Myeloma was the 10th most common cause of cancer deaths for women in 2000-2004. The onset of myeloma interferes with normal production of antibodies and makes myeloma patients susceptible to infections.424 people in the United States are living with myeloma.4 33. Total survival for white males. 15-19. the patient’s own stem cells are used (autologous stem cell infusion).940 women) new cases of myeloma will be diagnosed in the United States in 2007. Age-Specific Incidence Rates for Myeloma. It is 71 for African-Americans. 20-24). 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.5/100.5 3. • The median age at diagnosis is 70. causing pain and crowding out normal blood cell production. 10-14.000). Malignant plasma cells produce an abnormal protein called monoclonal immunoglobulin. Thalidomide is approved by the FDA for use in treating newly diagnosed myeloma. 1-4. Living with Myeloma An estimated 60. Treatment may include intensive chemotherapy followed by stem cell transplantation to restore normal blood cell production.1 0. Epidemiology and End Results) Cancer Statistics Review 1975-2004.4 35. especially. Treatment is aimed at slowing progress of the disease.3/100. Usually. The highest rates are found in black men 80 to 84 years of age and older (105/100.0 37. 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. National Cancer Institute. Bortezomib has been approved for treating myeloma in patients who have had at least two prior therapies. *<16 cases for each age interval.1 21. • The median age at diagnosis for African-Americans is 67. and it rarely occurs in people under age 45. tire more easily and feel weak.
3 2.5 Table 8: Source: SEER (Surveillance.000 Population (2000-2004) Type Leukemia Non-Hodgkin lymphoma Hodgkin lymphoma Myeloma Overall 12.3 Male 13.2 14.3 2. 2007.9 2. (Based on SEER 17 areas.4 11. per 100.6 Male 16.2 18. National Cancer Institute.2 2. Epidemiology and End Results) Cancer Statistics Review 1975-2004. Lymphoma and Myeloma The following tables showing incidence rates for leukemia.) Table 9: Source: SEER (Surveillance.0 Female 8. Hodgkin and non-Hodgkin lymphoma and myeloma use figures from 2000-2004.) Incidence Rates by Gender.2 Male 16. Incidence Rates by Gender.9 17.2 3.000 Population (2000-2004) Type Leukemia Non-Hodgkin lymphoma Hodgkin lymphoma Myeloma Overall 10.000 population and are age-adjusted to the 2000 population.) LEUKEMIA page 14 LYMPHOMA MYELOMA .1 2.8 20.5 Incidence Rates by Gender.2 6. Epidemiology and End Results) Cancer Statistics Review 1975-2004.1 11.1 9. National Cancer Institute.6 4.6 2. (Based on SEER 17 areas.9 5.Incidence Rates: Leukemia.7 24. Epidemiology and End Results) Cancer Statistics Review 1975-2004.4 4. 2007. per 100.6 Female 9. 2007.1 Table 10: Source: SEER (Surveillance.0 23. for Whites. the most recent available.3 19. National Cancer Institute. per 100.0 2.000 Population (2000-2004) Type Leukemia Non-Hodgkin lymphoma Hodgkin lymphoma Myeloma Overall 12. for Blacks.1 3. Rates are per 100.0 Female 9.8 14.0 7.7 5. (Based on SEER 17 areas.5 16. All Races.
*Estimate is fewer than 50 cases. They cannot be compared with previous years’ estimates to determine cancer incidence trends.830 240 230 60 * 1.070 110 1.660 210 * 190 120 1. Numbers are rounded to the nearest 10.170 480 1.560 770 890 3.790 330 * 320 200 1. 1969-2004.520 310 3. 2007. American Cancer Society. ***Hodgkin lymphoma estimates are not available for 2007.160 140 50 360 440 170 320 * 18.550 2. **State estimates may not add up to U.S. Note: These estimates are offered as a rough guide and should be interpreted with caution.070 Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Dist..410 130 50 500 490 130 490 * 21. Note: These estimates are offered as a rough guide and should be interpreted with caution. American Cancer Society.190 290 * 280 200 1.Estimated New Cases of Blood Cancers by Site.300 470 90 100 750 430 300 220 290 310 110 320 420 660 350 170 500 80 110 130 90 600 120 1.130 300 80 900 960 300 1.680 920 340 890 170 290 330 190 1. Used with permission. 2006.240 740 80 1. Centers for Disease Control and Prevention. January/February 2007.410 560 * 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** 350 * 400 240 2.030 570 * 610 210 360 1.070 80 330 70 480 1. Used with permission. CA A Cancer Journal for Clinicians.160 1. numbers are small and NCI and ACS are having difficulty fitting them into the Pickle et al.540 1.670 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. LEUKEMIA LYMPHOMA MYELOMA page 15 .550 * * * * *20 * * * * 60 * * * 50 * * * * * * * * * * * * * * * * * * 70 * * 50 * * 60 * * * * 80 * * * * * * * 390 Table 11: Sources: Cancer Facts & Figures 2007. 2007 State Leukemia Non-Hodgkin Lymphoma Myeloma Hodgkin Lymphoma Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Dist.310 800 600 900 920 330 1.080 1. National Center for Health Statistics.610 150 2. total because of rounding and exclusion of estimates that are fewer than 50 cases.330 260 780 180 1. Mortality Public Use Data Tapes.S.080 600 7.710 570 500 2.140 380 140 1.630 540 80 120 990 510 310 230 320 330 100 390 490 770 400 210 460 80 150 160 100 680 120 1. The method of derivation. total because of rounding and exclusion of estimates that are fewer than 50 cases. by State. Table 12: Sources: Cancer Facts & Figures 2007. 2007 State Leukemia Non-Hodgkin Lymphoma Myeloma Hodgkin Lymphoma*** Estimated Deaths from Blood Cancers by Site.360 610 * 950 290 260 1.010 1.370 250 280 2.030 910 620 420 680 680 250 630 1.040 70 44.050 140 140 * * 680 310 * 50 440 240 130 120 170 180 60 220 250 420 190 110 240 50 70 80 50 270 70 650 360 * 460 120 160 550 * 200 * 270 720 70 * 250 220 70 200 * 10.150 290 270 70 * 1.530 1. Numbers are rounded to the nearest 10. **State estimates may not add up to U.500 430 1.180 4.240 170 550 130 800 3. and additional data supplied by the American Cancer Society based on data from the U. which is new for 2007.300 110 63.250 1.610 670 610 110 60 3. *Estimate is fewer than 50 cases.360 960 170 220 2.370 100 * 430 380 130 350 * 19.140 60 260 80 410 1.190 880 870 170 100 4. 2007.S. is described by Pickle et al.510 500 60 70 900 380 220 160 280 430 100 370 460 730 310 170 400 70 110 120 80 650 120 1.390 1. model (see below). by State. and additional data supplied by the American Cancer Society.200 350 4.880 240 250 50 50 1.260 220 400 420 290 2.
It includes new (incidence) and preexisting cases and is a function of both past incidence and survival. 2007. Census. The SEER (17 region) data cover only about 26 percent of the U. LEUKEMIA page 16 LYMPHOMA MYELOMA .S. The description of the methods used was published in Pickle et al. 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.” We are using the “29-year limited duration” prevalence figures.) Prevalence is the estimated number of people alive on a certain date in a population who previously had a diagnosis of the disease. prevalence numbers reported may vary depending upon the method used to determine them. Thus. This change means that the 2007 incidence estimates are not comparable with previous estimates for determining cancer incidence trends. Definitions Incidence is the number of newly diagnosed cases for a specific cancer or for all cancers combined during a specific time period. population) that belong to the National Program of Cancer Registries. cancer or otherwise. if a person is initially diagnosed with melanoma and later develops leukemia. in comparison to the 2002 SEER report. population. mostly upward. Bureau of the Census’ 2000 population data for that region. the data presented in the 2007 SEER report placed online on April 15. In some prevalence statistics. The data presented in this report are an extrapolation or estimate of the number of cases reported by the 17 Surveillance. CA A Cancer Journal for Clinicians. may be incomplete in some cases and the data may reflect adjustments that anticipate changes that will occur once the actual data are received. 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. no matter how long ago that diagnosis was.” as per SEER table I-21.. in some cases fewer than 17 SEER regions) and death data from the National Center for Health Statistics. but these figures do not take into account differences in geography. race and ethnicity in various regions and region-specific health risks. his or her survival with leukemia may not be counted in leukemia prevalence statistics. Epidemiology and End Results Program (SEER) regions (or.S.S. When expressed as a rate. state-by-state data for incidence of Hodgkin lymphoma are not available because these numbers are so small. so the exact number of cases is not known. it is the number of new cases per standard unit of population during the time period. It considers deaths from all causes. especially in looking at populations in which individuals have had more than one type of cancer. Incidence rates can be calculated based on a number of factors such as age.S. based on the “first invasive tumor for each cancer site diagnosed during the previous 29 years (1975-2003). This year. In this report. Because of reporting delays from some of the SEER regions. Relative survival rate is an estimate of the percentage of patients who would be expected to survive the effects of the cancer. 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. Prevalence may be calculated in a number of different ways. only the first diagnosed cancer counts. January/February 2007. (Observed survival is the actual percentage of patients still alive at some specified time after diagnosis of cancer.Notes and Definitions Notes The United States does not have a nationwide reporting system or registry for blood cancers. 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. The specified date is 1/1/2004 for the prevalence estimates. estimates of cancer incidence. The relative survival rate is a comparison of survival to a person who is free of the disease. The data can be extrapolated for the entire United States by multiplying by the population ratio. Thus. the American Cancer Society changed its method of estimating cancer incidence. survival and mortality have been revised. 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. Because of changes in the information — such as racial classification — gathered in the 2000 U. 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 this change in method. race or sex.
Clegg L. Shu X-O. Eisner MP.org/cgi/content/full/57/1/30. MD.com/cgi/content/full/12/1/20. Bleyer A. “Cancer Statistics. Keller F. Barr R. posted to the SEER Web site 2007. Nachman J. In Cancer Epidemiology in Older Adolescents and Young Adults 15 to 29 Years of Age. Zou Z. Barr R. National Cancer Institute. MD. 25-38.” Hayat MJ. Feuer EJ. Ross J. Epidemiology. pp. and End Results) Cancer Statistics Review. Horner MJ. Atlanta: American Cancer Society. Atlanta: American Cancer Society. Cancer Facts & Figures for African Americans 2007-2008. http://seer. 2007. NIH Pub. Hachey M. Including SEER Incidence and Survival: 1975-2000. National Cancer Institute. 2007. CA A Cancer Journal for Clinicians Vol. 2007. Howe HL. 065767. Bethesda. Bleyer A.cancer. National Cancer Institute. Miller BA. 2006. 1975-2004. Melbert D.” O’Leary M. Including SEER Incidence and Survival: 1975-2000.” Bleyer A. NIH Pub. No. The Oncologist Vol. pp. No. “Lymphomas and Reticuloendothelial Neoplasms. In Cancer Epidemiology in Older Adolescents and Young Adults 15 to 29 Years of Age. Howlander N. Barr R. Ries LAG (eds). 2007. 30-42. pp. O’Leary M. Edwards BK (eds). Trends. 065767. and Multiple Primary Cancer Analyses from the Surveillance.” Pickle LW.gov/csr/1975_2004/ LEUKEMIA LYMPHOMA MYELOMA page 17 .” Mattano L Jr. 20-37. pp. 06-5767.amcancersoc.Citations Source Citations Cancer Facts & Figures 2007. O’Leary M. No. “A New Method of Estimating United States and State-Level Cancer Incidence Counts for the Current Calendar Year. Tiwari RC. http://caonline. Howlader N. Bethesda. 57. January. 2006. 39-51. Feuer EJ. 12. “Leukemias. January/February. 174. Krapcho M. SEER (Surveillance. In Cancer Epidemiology in Older Adolescents and Young Adults 15 to 29 Years of Age. Edwards BK. http://www. “Highlights and Challenges. Bleyer A. Jemal A. MD. Mariotto A. Bethesda. MD.TheOncologist. National Cancer Institute. Bethesda. O’Leary M. Ries LAG (eds). Reichman ME. Ward E. NIH Pub. p. Reichman M. and End Results (SEER) Program. Including SEER Incidence and Survival: 1975-2000. based on November 2006 SEER data submission. Barr R. Cheson B. Sheaffer J. Stock W. Ries LAG (eds). 2006. Hao Y. Ries LAG. Epidemiology.
leading to better survival rates and prevention measures for patients. Special Fellows and Fellows) pursuing careers and is stratified into two separately reviewed programs in basic or clinical research: Basic Research • Scholars are awarded $110.000 per year for three years. The Grant Review Process Scientists and physician-scientists who are experts in the field of leukemia. 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. Translational Research Program The Translational Research Program provides early-stage support for research on leukemia. 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. • Fellows are awarded $50. are granted each year.000 a year for a total of $150. Translational Research and the Specialized Center of Research (SCOR). research reaching a clinical trial can receive $1 million over five years to facilitate new drug discovery or advances in diagnosis or prevention.000 over three years. Thus. lymphoma and myeloma should be encouraged worldwide. to a total cost of $6. 2) CDP-clinical research. They are: 1) Career Development Program (CDP)-basic research. lymphoma. Research Research Grant Programs The Society’s research programs are based on the belief that all scientifically sound approaches toward a cure for. • Special Fellows are awarded $60. and improve the quality of life of patients and their families. Translational Research • Scholars in Clinical Research are awarded $110.000. Awards up to $200.25 million per year over a five-year period. Awards go to those groups that best demonstrate the synergy that will occur from their close interaction. 3) Translational Research Program. Now supporting $61.000 over three years.6 million annually on research. the Society’s grant programs are among the most prestigious in the fields of blood cancers. lymphoma and myeloma. Research grants are awarded in three program areas: Career Development.000 a year for a total of $180. lymphoma and myeloma that is intended to advance treatment.000 over three years. The program is expected to generate new knowledge and breakthrough discoveries. treatment or prevention of leukemia.000 a year for a total of $550. or control of. Hodgkin’s disease and myeloma. lymphoma or myeloma. We offer a wide variety of programs and services in support of our mission: Cure 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 Specialized Center of Research (SCOR) in Leukemia.000 over five years. The SCOR grants also support scientific core laboratories to provide access to innovative technology if required by the participating research programs. Each SCOR is funded up to $1.000 a year for a total of $180.000 over five years.25 million. Career Development Program The Career Development Program supports promising young scientists (Scholars. The SCOR program brings together research teams working in complementary areas. lymphoma and myeloma research comprise four review subcomittees. Since the first funding in 1954. • Special Fellows in Clinical Research are awarded $60. leukemia.000 a year for a total of $550. for a total of $600. 4) Specialized Center of Research Program that evaluate all grant applications in those programs and determine those applicants with the most innovative and LEUKEMIA page 18 LYMPHOMA MYELOMA . the Society has awarded more than $550 million in research grants. Funding for two additional years may be provided for highly promising projects that are entering phase I clinical trial. The participating scientists may be at different institutions or from any country. each focused on the discovery of new approaches to benefit patients or those at risk for developing leukemia.
Patients needing assistance may apply on the Society’s Web site. First Connection: This program links newly diagnosed patients to a peer volunteer who has experienced a similar diagnosis. 9 a. Family Support Group locations.LLS.LLS. sponsored by the Society. audio. brochures and videos through the IRC and local Society chapters. Co-Pay Assistance Program Patients with AML. myelodysplastic syndromes (MDS) and other blood cancers.org. Educational Materials An extensive collection of free educational materials are offered to patients and health professionals.important projects to advance the Society’s mission.org or by or emailing researchprograms@LLS. The Society also hosts numerous teleconferences and Webcasts. where medical professionals share the latest research findings.” Chapter Programs: Family Support Groups: The Society has developed more than 360 Family Support Groups at 68 chapters. including support groups. Patient Services The Society has a network of 68 chapters throughout the United States and Canada. www.m.m. clinical trials and offer guidance on coping.m. Much of the content of these materials is available to view and download at www. www. This support should advance the understanding. lymphoma. Professional Education The Society serves the continuing educational needs of the medical and research community through professional symposia offered throughout the year.org/copay. families.org. Each year. families and professionals may call the IRC toll free at (800) 955-4572 in addition to corresponding by email at infocenter@LLS.m. The Society’s Web Site The Society’s Web site. 2007 the Society will have 379 active grantees at 116 institutions in the United States and abroad. Information Resource Center (IRC) The Society strives to be the world’s foremost source of information on leukemia. They are available to talk one-onone.LLS. the Society’s programs and services. Information specialists are oncology social workers and health educators who provide callers with current information on blood cancers. www.LLS. ET. It is continually being updated and expanded to support and promote the Society’s mission.org. Monday through Friday. Guided by two volunteer oncology health professionals. Guidelines. instructions. serves a wide variety of education and information needs. Patients. is held each December on the Friday immediately before the American Society of Hematology meeting. on the Society’s Web site.org or faxing to (914) 949-6691 or contacting the Research Department at (914) 949-5213. The Society funds several Focused Workshops each year on important topics relevant to hematological malignancies. to 5:00 p. ET. Information on registration for these free events can be accessed at www. Teleconferences and Webcasts The Society sponsors more than 25 educational teleconferences and Webcasts each year on topics of interest to patients and caregivers.LLS. peer counseling and patient financial aid. each group provides information and support. The user has the opportunity to create personalized pages with identified interests. their families and healthcare professionals.org. lymphoma. These offices conduct lifeenhancing patient services. information about our peer-to-peer program First Connection and other programs. the Translational Research Grant Progress Review Meeting and the SCOR Progress Review Meeting. and encourages greater communication among patients. treatment and prevention of leukemia. The site features a comprehensive overview of blood cancers. Other meetings are held for the Society’s grantees.org. myeloma. A trained patient volunteer currently in remission phones the new patient to share information and support. and applications for the Society’s three research programs may be obtained by visiting www. podcasts and Webcast archives of these programs are available at www.org. You may also chat online with an information specialist.org. from 10:00 a. the Society distributes more than 1 million booklets. The IRC is a worldwide link to information and resources useful to patients. and click “Live Help. The Annual Research Symposium.LLS.LLS. These include the Stohlman Scholar Symposium. The educational program offers varying formats to facilitate the exchange of information and ideas on the newest developments in cancer research and treatment. to 6 p. lymphoma and myeloma. friends and healthcare professionals. LEUKEMIA LYMPHOMA MYELOMA page 19 . 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. call (877) LLS-COPAY ( 557-2672) or email copay@LLS. treatments. As of June 30.
the Society’s advocacy program has been a strong voice in Washington. This program is provided through an unrestricted educational grant from Millennium Pharmaceuticals. drugs and various treatments not covered by insurance. how cancer drugs are developed and what the emerging treatment options are for leukemia. DC. lymphoma and myeloma. Department of Defense’s medical research program. staging and classification of nonHodgkin lymphoma (NHL). unrestricted educational grant from Genentech BioOncology and Biogen Idec Inc. treatments. This Society program is being supported by Celgene Corporation and Millennium Pharmaceuticals. videos and other materials to aid the process are available through all local chapters.S. Meet the Expert on Non-Hodgkin Lymphoma: This program presents basic information on terminology. patients and school personnel to assure youngsters a smooth transition from active treatment back to school.000 and has become a potent voice in public policy deliberations. The Path to Progress: Clinical Trials in Blood Cancers: This program provides patients. emerging therapies and side effects and addresses the unique challenges of nursing management of these patients. This program is being sponsored by an unrestricted education grant from Novartis 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. this education program discusses possible emotional and cognitive short. risk factors. Printed literature. Through the Patient Financial Aid Program. That network now numbers more than 35.Patient Financial Aid Program: For more than 31 years. This program is made possible by the Lance Armstrong Foundation.and long-term effects that children may experience after treatment. 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.LLS. Working through chapters across the country. The Society has identified key issues that currently shape its advocacy agenda. Welcome Back: Facilitating the Return to School for Children with Cancer: A new addition to The Trish Greene Back to School Program. The patient education program was funded at $18 million through 2007. treatments and future directions for NHL are also discussed. providing additional support for blood cancer patients and their families nationwide. LEUKEMIA page 20 LYMPHOMA MYELOMA . Patient financial aid funds are subject to availability. reimbursement of up to $500 per year helps cover the costs of transportation. 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. On the state level. that program has funded some $30 million in additional blood cancer research. emerging therapies and managing side effects and how to find emotional support when living with the illness. representing to policy makers at all levels of government the healthcare quality concerns and medical research interests of patients and their families. Advocacy Since 1994. and offers numerous resources that can assist childhood cancer survivors to flourish in the school environment posttreatment. diagnosis. In 2002. This program is also accessible as a Webcast at www.org and is being sponsored by a generous. New insights. The Trish Greene Back to School Program for Children with Cancer: This program is designed to increase communication among healthcare professionals. the Society has helped patients demonstrating a need for financial assistance cover a portion of their treatment costs. It is supported by Amgen Oncology. 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. In 2001. New Directions in Myeloma Therapy: This program presents an overview of myeloma. This nursing education program provides an overview of CML. the Society successfully lobbied Congress to institute a blood cancer research initiative as part of the U. To date. Society volunteers and staff visit Capitol Hill regularly to lobby Congress in support of issues that impact research and patient care. families and healthcare professionals with a clear description of what clinical trials are. 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. CML Issues and Insights: A Nursing Education Program on Chronic Myelogenous Leukemia. parents.
with the understanding that the Society is not engaged in rendering medical or other professional services. provided statistical assistance.cancer.seer. The Leukemia & Lymphoma Society extends special thanks to Myrna Watanabe. NCI. of the American Cancer Society (ACS). This publication is designed to provide information in regard to the subject matter covered. Ph. It is distributed as a public service by The Leukemia & Lymphoma Society Inc.Acknowledgements Additional data from SEER*Stat Databases at http://www. .. and Rebecca Siegel. for compilation of data for this publication.D.gov. Milton Eisner of SEER. provided ACS’s state-by-state statistics on myeloma and Hodgkin lymphoma.
corporate and foundation contributions to advance its mission. lymphoma.LLS. and improve the quality of life of patients and their families.Home Office 1311 Mamaroneck Avenue. Hodgkin’s disease and myeloma.org Our mission: Cure leukemia. Suite 310 White Plains. The Society is a nonprofit organization that relies on the generosity of individual.955.HELP. PS80 35M 6/07 .LLS Information Resource Center (IRC): 800. New York 10605 Tel: 888.4572 www.
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