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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.
405. 2nd Edition. 19. is a compilation of the most recent data on leukemia. 2007 and SEER 19731993. 10. and myeloma.313 either have or are in remission from Hodgkin lymphoma.660 from non-Hodgkin).730 people will die from lymphoma (1.1975-1977 vs.070 from Hodgkin. the incidence of myeloma increased 8 percent.900 people will be diagnosed with myeloma. www. *Myeloma Biology and Management. Highlights from the Report Include: New Cases • An estimated 135.920 new cancer cases diagnosed in the United States this year. Epidemiology and End Results Program. page 16).cancer. LEUKEMIA LYMPHOMA MYELOMA page 1 . 1996. National Cancer Institute. Survival • An estimated 823. • Every 10 minutes.Executive Summary Facts 2007-2008. Hodgkin and non-Hodgkin lymphoma and myeloma will account for nearly 9.790 people will die from myeloma. • In 2007. or nearly six people every hour. and its age-adjusted incidence rose by nearly 84 percent from 1975 to 2004. This year. 21. Deaths • Leukemia. 18. • Leukemia causes more deaths than any other cancer among children and young adults under the age of 20.520 people in the United States will be diagnosed with leukemia.380 new cases of lymphoma will be diagnosed in the United States (8. • Every five minutes. 1975-2004.190 cases of non-Hodgkin).seer. Cancer Statistics Review 1975-2004 (see Notes. Epidemiology and End Results) Cancer Statistics Review. Leukemia.424 people living today with myeloma. Oxford University Press. Five-Year Relative Survival Rates 1960-1963 vs. lymphoma and myeloma decreased from 1995 to 2004 (the last year data were available). the National Cancer Institute’s Surveillance. This statistic represents 143 people each day. someone dies from a blood cancer. • This year. an annual publication. • In general. This abnormal accumulation interferes with the production of healthy blood cells. 1960-1963 1975-1977 1996-2003 Figure 1: Sources: SEER (Surveillance.444.gov. • Eighty-six percent of myeloma cases occur in people aged 55 and over.266 people living today with lymphoma. *except acute myelogenous leukemia (AML) and other.240 people will be diagnosed with leukemia. From 1975 to 2004. 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. 44. lymphoma and myeloma will cause the deaths of an estimated 52. the likelihood of dying from most leukemias*. • Non-Hodgkin lymphoma is the fifth most common cancer in the United States.790 people will die of leukemia. More males are diagnosed with leukemia and more males die of it than females. 1998. National Cancer Institute.349 Americans are living with leukemia. nonacute myelogenous and monocytic leukemias Lymphoma: • There are 544. which becomes malignant and multiplies continuously. • New cases of leukemia. • These blood cancers will account for 9. The next SEER Cancer Statistics Review is expected to be published online in April 2008.650 total cancer-related deaths.659 people in the United States who are either living with or are in remission from leukemia.190 cases of Hodgkin. 138.310 people in the United States this year. 63. 71.953 either have or are in remission from non-Hodgkin lymphoma (NHL). lymphoma and myeloma. someone is diagnosed with a blood cancer. The data within Facts 2007-2008 reflect the most recent statistics available from SEER. in April 2007. • Thirty-two percent more males are living with leukemia than females. Hodgkin and non-Hodgkin lymphoma.4 percent of the 1. 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. lymphoma and myeloma in 2007. • In 2007. These data were published online by SEER. Myeloma: • • • • There are 60. Mortality from the disease increased 24 percent. This year. 19.3 percent of the deaths from cancer in 2007 based on the 559. • This year.
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. usually a brother or sister with the same tissue type. Patients with leukemia. Autologous transplantation uses the patient’s own marrow stem cells and is technically not transplantation since another person is not the donor. If a sibling is not available. studies suggest that two matched cord donors may result in a higher success rate in larger adults. usually in combinations of two or more drugs. The technique of harvesting stem cells from blood and cord blood has made transplantation available for more LEUKEMIA page 2 LYMPHOMA MYELOMA . Such an approach would greatly lessen the proportion of children without a donor. The harvesting. decreased ability to fight infections and a predisposition to bleeding. 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. These diseases usually result from an acquired genetic injury to the DNA of a single cell. 2007. which becomes abnormal (malignant) and multiplies continuously. Approximately 50 different drugs are now being used in the treatment of these diseases. especially for children. a search of the National Marrow Donor Program registry of tissue-typed volunteers could be made for a matched unrelated donor. An allogeneic transplant uses blood or marrow stem cells from a normal donor. is largely responsible for the dramatic improvement in managing leukemia and lymphoma. 2007. Syngeneic transplant describes the use of an identical twin as donor. for which a parent rather than a sibling could be the donor.) of larger adult patients. freezing and storing of cord blood have provided another source of stem cells for transplantation. American Cancer Society.About the Diseases Leukemia. Hodgkin and non-Hodgkin lymphoma and myeloma are cancers that originate in a cell in the bone marrow or lymphatic tissues. lymphoma and myeloma. myeloma and lymphoma are usually treated with chemotherapy. The numbers of stem cells in cord blood are often insufficient for the needs Figure 2: Source: Cancer Facts & Figures. (Numbers do not add up to 100% because of rounding. 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. 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. They are considered to be related cancers because they arise from cells with a common origin (the lymphohematopoietic stem cells) and with related functions. However. Stem cells also circulate in large numbers in fetal blood and can be recovered from umbilical cord and placental blood after childbirth. There are two major types of stem cell transplants: syngeneic and allogeneic. Patients with acute lymphocytic leukemia (ALL). Estimated New Cases (%) of Blood Cancers in 2007 Myeloma 15% Leukemia 33% Lymphoma 53% Treatment Chemotherapy and Radiotherapy: The use of chemotherapy (anticancer drugs). Research is being conducted to improve socalled “haploidentical” transplant. 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. The technique is important. especially in young children. Blood and Marrow Stem Cell Transplantation: Stem cell transplantation from marrow was introduced approximately 45 years ago and is now standard therapy for selected patients with leukemia. In special instances. The blood or marrow stem cells are collected while the patient is in remission.
thereby allowing doctors to plan treatment accordingly. The protein is an enzyme in the family of tyrosine kinases. Development of New Drugs: In the past decade. two second-generation agents. “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. Regular examinations may include screening for cancer recurrence or the development of secondary cancer or other late effects of treatment. lymphoma and myeloma. as well as marrow. lymphoma or myeloma is attacked and suppressed by donor lymphocytes that form from the donor stem cells. Cancer survivors should have physical examinations yearly or more often. Gleevec offers several dramatic advantages to patients: oral administration. as needed. or genetic factors that can increase susceptibility to certain effects. Biomarkers could be high levels of certain substances in the body such as antibodies or hormones. several important new drugs and new uses for existing drugs have greatly improved cure rates or remission duration for some patients with leukemia. making the procedure more tolerable. 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. few severe adverse effects on normal tissues and a very high response rate. This still experimental approach greatly lessens the early toxicity of transplantation and has extended the age at which recipients with leukemia. This “graft versus leukemia or lymphoma effect” can suppress (cure) the malignancy and is a prolonged (indefinite) form of immunotherapy. Stem cells not only reside in the marrow but also circulate in the blood.org/). Blood and cord blood transplants differ from marrow transplants principally in the source of the cells collected for transplant. Coordination between specialists and primary care physicians is essential to provide the best care possible. multi-disciplinary approach to monitoring and supporting cancer survivors. To ensure there will be enough blood stem cells for successful transplantation. Over time. decreased side effects. and Young Adult LEUKEMIA LYMPHOMA MYELOMA page 3 . New Approaches to Treatment Several areas of research have resulted in new approaches to the treatment of leukemia. Some treatment centers have follow-up clinics that provide a comprehensive. Because blood. Follow-Up Guidelines: The Children’s Oncology Group has established Long-Term Follow-Up Guidelines for Survivors of Childhood. 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. Follow-Up Care Regular medical follow-up enables doctors to assess the full effect of therapy. It works by blocking the oncogeneencoded protein product that instigates the transformation to a leukemic cell. these cells can be harvested from the blood of a donor. is a source of stem cells for transplantation. 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 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. the donor’s cells take hold and the patient’s leukemia. Imatinib mesylate (Gleevec®) is now the drug of choice in newly diagnosed patients with chronic myelogenous leukemia (CML). Cancer survivors should see their primary care physicians for general health examinations and an oncologist for follow-up care related to cancer. frozen and stored and later transplanted in the patient. donors of blood stem cells require special treatment to mobilize sufficient stem cells from marrow into their blood before cells are harvested. lymphoma or myeloma can have an allogeneic transplant. lymphoma or myeloma and permit the donor’s cells to be accepted by the temporarily immunodeficient recipient. In standard stem cell transplantation. Identifying these biomarkers will allow researchers to develop tests that can predict what effects an individual is at risk of developing. Adolescent. Cancers (http://www.patients. the recipient’s blood cell and immune system are preserved.childrensoncologygroup. ablation of the recipient’s blood-cell forming and immune cells was the price that had to be paid to eradicate the leukemia. In nonablative transplantation. but some follow adult cancer survivors. Although a minority of patients have developed resistance to the drug. marrow and immune system. “Ablation” referred to wipingout the recipient’s cancer. identify recurrence of the disease and detect long-term or late effects. Most follow-up clinics specialize in pediatric cancer survivors.
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. is being used to treat relapsed or refractory acute lymphocytic leukemia (ALL) in children who have received at least two prior therapies. Lenalidomide (Revlimid®). Three types of immunotherapy are being explored: antibody treatment. thalidomide (Thalomid®). approved by the FDA in 2005. Velcade is approved by the FDA for treating people with myeloma who have had at least one prior therapy. In patients with anemia. but it can also induce remissions in some cases of acute leukemia. perhaps 20 percent of cases also derive benefit. This drug is also being tested in clinical trials to treat adult acute leukemia and MDS. suppresses the progression of leukemia. Some patients with moderately severe. Revlimid is approved by the FDA in combination with dexamethasone for the treatment of myeloma patients who have received at least one prior therapy. It is especially active against the lymphocytes in CLL. 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. principally. Alemtuzumab (Campath®) is a monoclonal antibody directed against the antigen CD52 found on T and B lymphocytes. a thalidomide derivative. Immunotherapy: This is a treatment that uses immune cells or antibodies to fight the disease. lymphoma or myeloma. Rituximab is an antibody directed at the target CD20 antigen on B-cell lymphoma cells. has improved dramatically with the introduction of cladribine. chronic eosinophilic leukemia (formerly hypereosinophilic syndrome). Azacitidine (Vidaza®).dasatinib (Sprycel®)(approved by the U. Pentostatin is another effective drug that can be used in patients with hairy cell leukemia who do not respond to cladribine. Indeed. 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). symptomatic anemia have improvement in hemoglobin levels with this agent. Patients with more severe forms of MDS are very unlikely to respond to the agent. 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®). the most prevalent lymphoma subtype. Monoclonal Antibody Therapy: Monoclonal antibodies are laboratory-produced proteins that can be infused into an appropriate patient. LEUKEMIA page 4 LYMPHOMA MYELOMA . Other therapies in clinical research to treat MDS include arsenic trixoxide. 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. 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. Clofarabine (Clolar®). Gleevec is not only a very important new agent in the treatment of CML. it has now become an important fifth drug in the R-CHOP–rituximab. cyclophosphamide. however. reducing the need for transfusions in some patients. In May 2006. was approved by the FDA for newly diagnosed myeloma. Rituximab has become an important agent to treat CD20-positive lymphocytic malignancies. and enhances the specificity of treatment to minimize toxic effects on normal tissues. although initially used in indolent lymphomas. PDGFR or KIT oncoproteins). vincristine (Oncovin®) and prednisone–therapy for diffuse large B-cell lymphoma. and Decitabine (Dacogen®). immune cell administration and vaccine development. The treatment of hairy cell leukemia. 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. farnesyl transferase inhibitors and reduced-intensity stem cell transplantation. such as follicular lymphoma. Arsenic trioxide also adds to the drugs available to treat this subtype of acute leukemia. approved by the FDA for all types of MDS. Early studies indicate the combination of arsenic trioxide and all-trans retinoic acid may be a further advance in the initiation of therapy. are entering clinical use and can overcome this resistance in some cases. doxorubicin (Adriamycin®). a less common type of chronic lymphocytic leukemia (CLL).S. in combination with dexamethasone. kill unhealthy bone marrow cells and may help the bone marrow function more normally in MDS patients. but without this specific chromosome 5 abnormality. Monoclonal antibodies have added to the arsenal of agents that are used for the treatment of patients with lymphoma and leukemia. thus rituximab is an anti-CD20 antibody.
Monoclonal antibodies can also be linked to a radioactive isotope to target and kill specific cancer cells. 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. Paradoxically. These are called conjugated monoclonal antibodies. In some approaches. In patients with CML who have relapsed after stem cell transplantation. The goal is to extend the duration of remission achieved by remissioninduction therapy of various types. or become. drugs are designed to interfere with the oncoprotein and prevent its effect on the cell. Examples of this treatment are the drugs ibritumomab (Zevalin®) and tositumomab and iodine I131 tositumomab (Bexxar®). The goal of several new agents being studied is to decrease resistance to an important chemotherapy drug used in leukemia. Vaccines: Experimental treatment vaccines are now being studied to treat certain types of lymphoma. If the gene in the former case is an oncogene or the protein in the latter case is an oncoprotein. the infusion of the original marrow donor’s lymphocytes can re-induce remission. the basis for the vaccine is to make the cancer cells susceptible to immune attack by heightening the recognition of markers on the cancer cells. 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. 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. Approaches to reversing multidrug resistance are under study. less responsive to therapy. LEUKEMIA LYMPHOMA MYELOMA page 5 . These cells are. and aptamer treatment. b) a modality that uses molecules of RNA to silence complementary (DNA) genes. In each case. 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. new forms of cancer therapy may be developed. Vaccines are in clinical trials for types of acute and chronic leukemia. cells are isolated in the laboratory and start making antibodies after insertion of the cancer antigen. myeloma and 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. is approved for older patients with AML who relapse after initial treatment. Two new and potentially important approaches include a) the application of RNA interference. Studies of vaccines used in patients with follicular or indolent lymphoma have demonstrated an immune response. some vaccines are made from leukemic cells treated in test tubes to convert them to potent antigen-presenting cells. This means that the vaccine induces an immune response against the cancer cells present in the patient. These drugs have been approved to treat relapsed B-cell non-Hodgkin lymphoma. DNA vaccines that contain the DNA that encodes the specific antigen are being tested. Many cancer treatment vaccines under development are intended to induce antigen-specific antitumor immune responses. gemtuzumab (Mylotarg®). 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.Another antibody that has been approved for use by the FDA to treat certain patients with acute myelogenous leukemia (AML) is linked to a chemical toxin called calicheamicin. These types of vaccines would be used in patients who have small amounts of residual blood cancer after chemotherapy or stem cell transplantation. In another approach. lymphoma and myeloma. In studies of CML. An alternative strategy called molecular targeted drug development targets the oncoprotein. In one approach. 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. This drug. Patients with myeloma have also had remission re-induced by donor lymphocytes. lymphoma or myeloma cells. 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.
based on the November 2006 SEER data submission. Table 3: Source: Cancer Facts & Figures 2007. Statistical Research and Applications Branch.150 24. Approximate U. develops in virtually all leukemia patients. • Most cases of leukemia occur in older adults.410 4. Epidemiology.S. and End Results) Cancer Statistics Review 1975-2004. 2007. National Cancer Institute. males are expected to account for 56 percent of the new cases of leukemia.659 people in the United States are living with leukemia.579 21. Chronic leukemia progresses more slowly and allows greater numbers of more mature. Estimated 29-Year L-D Prevalence Counts on 1/1/2004 by Duration. Acute leukemia is a rapidly progressing disease that results in the accumulation of immature. The lack of normal white cells impairs the body’s ability to fight infections.340 13. functional cells to be made. Nearly 54 percent of the new cases of this disease will occur among children in 2007 (about 2. It is characterized by the uncontrolled accumulation of blood cells. 2007.380 6. The marrow often no longer produces enough normal platelets.570 5. each of which can be acute or chronic. The four major types of leukemia are shown in Table 1. Only 2. Incidence by Gender Incidence rates* for all types of leukemia are higher among males than among females. NCI.350 2. (About 40. New Cases An estimated 44. 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. Prevalence of the Four Major Leukemias as of Jan. Leukemia is divided into four categories: myelogenous or lymphocytic.790). DCCPS.) • The most common types of leukemia in adults are acute myelogenous leukemia (AML) and chronic lymphocytic leukemia (CLL). and SEER Program. aged 0-19. • About 33 percent of cancers in children aged 0-14 years are leukemia • Most cases of chronic myelogenous leukemia (CML) occur in adults.000 2. Anemia. released April 2007.4 percent of leukemias in children aged 0-19 are CML. *Prevalence estimates are expressed here as the number of people living in whom the first involved tumor for each cancer site was diagnosed during the previous 29 years. The incidence rates are usually presented as a specific number per 100.289 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 5.570 3. *Note: Incidence rates are the number of new cases in a given year not counting the preexisting cases.440 Table 2: Sources: SEER (Surveillance. Surveillance Research Program.060 8.200 15. The terms myelogenous or lymphocytic denote the cell type involved. 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. American Cancer Society. In 2007.189 27.570 19. 2004 Type Chronic lymphocytic leukemia Chronic myelogenous leukemia Acute lymphocytic leukemia Acute myelogenous leukemia Prevalence* 95. Chronic leukemias account for 7 percent more of the cases than acute leukemias.800 Female 2.000 population.140 6.960 7. red blood cells and white blood cells.240 new cases of leukemia will be diagnosed in the United States this year.Leukemia Leukemia is a malignant disease (cancer) of the bone marrow and blood.240 Male 3. 1. LEUKEMIA page 6 LYMPHOMA MYELOMA .440 adults compared with 3. Prevalence database: U. A shortage of platelets results in bruising and easy bleeding.800 children.720 44.060 2. a deficiency of red cells.501 50. • The most common form of leukemia in children is acute lymphocytic leukemia (ALL).S.
Leukemia is one of the top 15 most frequently occurring cancers in minority groups. The incidence rate for all cancers among AfricanAmericans in the Seer (17 region). The diagnosis of leukemia requires specific blood tests.800 children will be diagnosed with leukemia throughout the United States. averaging about 189. The leukemias represented 27 percent of all cancers occurring among children younger than 20 years from 2000-2004. LEUKEMIA LYMPHOMA MYELOMA page 7 . leukemia rates are higher in Americans of European descent than among those of African descent. Leukemia incidence is highest among whites and lowest among American Indians/Alaskan natives. Figure 3: Source: Cancer Facts & Figures 2007.000 population.5 times that of ALL. The incidence of ALL among 1. 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). Some people with chronic leukemia may not have major symptoms and are diagnosed during a medical examination.790 new cases of childhood ALL are expected to occur in 2007. Leukemia strikes all ages and both sexes. Among 15. These cancers are most prevalent in the seventh. American Indian/Alaskan natives. white and Asian/Pacific islander children than for black children. Incidence by Age-Group Incidence rates by age differ for each of the leukemias. The most common form of leukemia among children under 20 years of age is ALL. CLL incidence increases dramatically among people who are aged 50 and older. They do warrant medical evaluation. including 3. Most children under 15 years of age with ALL are cured.799 children under the age of 20 diagnosed with leukemia from 2001-2004. ALL incidence was approximately twice that of AML. The cause of leukemia is not known. CML incidence also increases dramatically among people who are aged 60 and older. In 25. About 2. 2007. there were 4.922 cases per year. Hispanic children of all races under the age of 20 have the highest rates of leukemia. Leukemia rates are substantially higher for Hispanic.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. Children. from 2000-2004. Adolescents and Young Adults.to 19-year olds. American Cancer Society. the incidence of AML slowly rose while that of ALL steadily decreased in the period from late adolescence to older adulthood. It is estimated that in 2007. was 504 per 100. eighth and ninth decades of life. In the 17 SEER regions of the United States. Although chronic exposure to benzene in the workplace and exposure to extraordinary doses of irradiation can be causes of the disease. AML incidence was approximately 1. From 1975 to 2000. neither explains most cases. 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.900 new cases of cancer diagnosed in African-Americans in 2007. These signs are not specific to leukemia and may be caused by other disorders. However. Possible Causes of Leukemia Anyone can get leukemia.619 with ALL. including the examination of the cells in blood or marrow. Adults. 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. and AML incidence increases dramatically in people who are aged 60 and older.to 29-year olds.Estimated Proportion of New Cases (%) in 2007 for Each Type of Leukemia Including Adults and Children 3.
2 1. By 1975-1977.9 20-24 0.3 3. National Cancer Institute.1 Incidence (per 100.Age-Specific Incidence Rates for Acute Myelogenous Leukemia (All Races). During 1996-2003.1 for children under 15 • CML: 44.4 percent for children under 5 • CLL: 74.4 percent Five-Year Relative Survival Rates for All Ages.6 10-14 0. 2007.2 10.9 15-19 0. when compared to a person without leukemia.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. Treatment centers report increasing numbers of patients with leukemia who are in complete remission at least five years after diagnosis of their disease. gender. In 1960-1963. race and type of leukemia.2 23 21 19 19. and in 1996-2003. 2007.8 1-4 0. The relative survival rates differ by age of the patient at diagnosis. a patient had a 14 percent chance of living five years. Epidemiology and End Results) Cancer Statistics Review 1975-2004.2 15 13 11 9 7. Thirty-two percent more males than females are living with leukemia. the five-year relative survival rate had jumped to 35 percent. Complete remission means that there is no evidence of the disease and the patient returns to good health with normal blood and marrow cells. a complete remission (no evidence of disease in the blood or marrow) that lasts five years after treatment often indicates cure. 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.000) 17 15.5 21. All Types Leukemia.1 4.3 percent overall.6 2. the five-year relative survival rates overall were: • ALL: 65. 90. For acute 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.9 25-29 1.8 percent • AML: 20. the overall relative survival rate was nearly 50 percent.4 5-9 0. The five-year relative survival rate has more than tripled in the past 47 years for patients with leukemia.4 <1 0. Epidemiology and End Results) Cancer Statistics Review 1975-2004. Treatment of Leukemia The aim of treatment is to bring about a complete remission.7 percent overall. National Cancer Institute. 54. Relapse indicates return of the cancer cells and the return of other signs and symptoms of the disease. LEUKEMIA page 8 LYMPHOMA MYELOMA .7 7 5 3 1 0 1. 2000-2004 25 23.3 1.
710 9.020 240 3.470 females.560 5. 2007. 2007. American Cancer Society. Epidemiology and End Results). 1975-2004. Zuelzer WW. 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. 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. There will be an estimated 8.Five-Year Relative Survival Rates for Acute Lymphocytic Leukemia.990 490 6. In 2007. deaths from leukemia are expected to be distributed in the following numbers: In 2007. Despite this decline.470 Table 4: Source: Cancer Facts & Figures 2007. Non-Hispanic whites diagnosed with leukemia over the age of 44 had the highest death rates during this period.500 deaths from CLL and 1. Cancer Statistics Review. leukemia causes more deaths than any other cancer among children and young adults under age 20. LEUKEMIA LYMPHOMA MYELOMA page 9 .990 deaths from AML and 490 deaths from CML. 1964:24:477-494. There will be an estimated 4. National Cancer Institute.940 3. In 2007.320 males and 9. Unclassified forms of leukemia will account for 6.390 additional deaths. SEER (Surveillance. leukemia will be the fifth most common cause of cancer deaths in men and the sixth most common in women.390 21. about 515 children under the age of 14 are expected to die from leukemia. 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. 2. Hispanics with leukemia who are under the age of 25 had the highest mortality rates from the disease between 1990 and 1999.970 250 2.320 Female 600 1. 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. unclassified forms of leukemia Total Overall 1.420 4. Sources: 1.790 Male 820 2.420 deaths from ALL. Deaths It is anticipated that approximately 21.500 8. Blood.790 deaths in the United States will be attributed to leukemia in 2007: 12. in Children Under 15 Years of Age.680 12. Implications of long-term survivals in acute stem cell leukemia of childhood treated with composite cyclic therapy. 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.
Incidence rates for Hodgkin lymphoma tend to be higher among males than among females.380 Table 5: Source: Cancer Facts & Figures 2007. while 0. After 50 to 54 years of age. More than four percent of all cases of Hodgkin lymphoma diagnosed in 2007 will be in children under 15 years of age.190 63. they are 52. Both Hodgkin and non-Hodgkin lymphomas are more common in males than in females. Age-specific incidence rates of non-Hodgkin lymphoma are 2. eventually crowding out healthy cells and creating tumors that enlarge the lymph nodes or other sites in the body.Lymphoma Lymphoma is a general term for a group of cancers that originates in the lymphatic system. Hodgkin Lymphoma Hodgkin lymphoma is a specialized form of lymphoma and will represent about 11.9 per 100. 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. Persons infected with the human immunodeficiency virus (HIV) have a much higher risk of developing lymphoma. including the presence of an abnormal cell called the ReedSternberg cell (a large. New Cases About 71.5 percent of all lymphomas diagnosed in 2007.9 per 100.190 71. LEUKEMIA page 10 LYMPHOMA MYELOMA .S.470 34. 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. Fifty-three percent of the blood cancers diagnosed are lymphomas. In 2004.190 cases of Hodgkin lymphoma and 63.313 people living with Hodgkin lymphoma (active disease or in remission) and 405. It is the sixth most common cause of cancer deaths in males and in females.953 people living with nonHodgkin lymphoma for a total of 544.990 32. or low.000 at ages 20 to 24 for males and 1. malignant cell found in Hodgkin lymphoma tissues). there are 138.190 cases of non-Hodgkin lymphoma). These risk factors explain only a small proportion of cases. Non-Hodgkin lymphoma is the fifth most common cancer in males and females in the United States. New Cases of Lymphoma by Gender. intermediate and high grade. 2007 Type Hodgkin lymphoma Non-Hodgkin lymphoma Total Male 4. American Cancer Society. incidence rates for non. Each histologic grouping is diagnosed and treated differently. By ages 60 to 64. population who are living with lymphoma. Incidence by Gender Table 5 illustrates the breakdown of incidence of lymphoma by gender. The groups are often classified as indolent or aggressive. and each has prognostic factors that categorize it as more or less favorable.266 members of the U.000 for males and 38.720 28.000 for females. The incidence of Hodgkin lymphoma is consistently lower than that of non-Hodgkin lymphoma.6 per 100.670 Female 3. Hodgkin lymphoma has characteristics that distinguish it from all other cancers of the lymphatic system.Hodgkin lymphoma are higher in Americans of European descent than among those of African descent. rose by 84 percent from 1975 to 2004.3 per 100.710 Total 8. 2007. in general whites have higher incidence rates than blacks. The bacterium Helicobacter pylori is associated with the development of lymphoma in the stomach wall.8 percent. an average annual percentage increase of 2.000 for females. The reasons for the development of non-Hodgkin lymphoma are not certain.7 percent of all cases of non-Hodgkin lymphoma will be diagnosed in children under 15 years of age this year. The Epstein-Barr virus causes Burkitt’s lymphoma in Africa.200 38. Lymphoma results when a lymphocyte (a type of white blood cell) undergoes a malignant change and begins to multiply.380 Americans will be diagnosed with lymphoma in 2007 (8. the difference was small. Immune suppression plays a role in some patients. Living with Lymphoma In the United States in 2007.
1 per 100. In children up to age 14 years. recurrent high fever. It has remained fairly constant since 1999. Death rates have been declining for Hodgkin lymphoma patients since the mid-1970s.000 by ages 60 to 64. loss of appetite and bone pain. 4.2 percent for Hodgkin lymphoma in people under 20 years of age.4 cases per 100. Hodgkin lymphoma incidence rates are higher in adolescents and young adults than in adults in their middle years. indigestion and abdominal pain.5 percent.9 percent).5 percent) are the third most common cancers in 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 1996-2003.730 persons will die from lymphoma in the United States in 2007 (18. chemotherapy or both may result in cures for most patients with Hodgkin lymphoma. and more than 46-fold to 112. LEUKEMIA LYMPHOMA MYELOMA page 11 . Hispanics of all races have the second highest incidence rates of non-Hodgkin lymphoma after whites. In children under 20 years of age. It is rarest among American Indian/ Alaskan native children. The incidence in this group decreased almost steadily and significantly between 1975 and 1999. widespread disease requires chemotherapy or chemotherapy and/or monoclonal antibody therapy with radiation. The rate increases more than 18 times to 45. most children with nonHodgkin lymphoma did not live five years after diagnosis. In children from 0 to 19 years of age. From ages 15 to 19. armpit.5 percent. 3. Treatment for non-Hodgkin lymphoma sometimes includes vaccines and other forms of immunotherapy.660 from non-Hodgkin lymphoma. Five-year relative survival is now 95 percent for Hodgkin lymphoma in children aged 0 to 14 years.8 percent) and neoplasms of the brain and other nervous tissue (17. Symptoms also often include fever.1 cases per 100. night sweats. This represents a significant improvement in the rate of recovery. and non-Hodgkin lymphoma.5/1 million population). about 10.Among women. armpit or groin.1 cases per 100. Early stage. The most common early sign of other forms of lymphoma is also painless swelling of the lymph nodes – usually 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. and is the eighth most common cause of cancer death in that group. Non-Hodgkin lymphoma is the fifth most common cancer in Hispanics. depending on the tumor size. Even in the mid-1970s. lymphomas are most commonly diagnosed in whites (24.000 children in 2004. Survival for Children Five-year relative survival is 95. Deaths An estimated 19. Adolescents are more commonly diagnosed with Hodgkin lymphoma than young children. sweating at night.to 24year-old individuals. cell type and location of the lymphoma. Radiation. Signs and Symptoms Signs and symptoms of Hodgkin lymphoma include painless swelling of lymph nodes in the neck.8 percent for all races in 1996-2003. following leukemia (26. localized non-Hodgkin lymphoma is sometimes treated with radiation.0/1 million population).000 people occur in 20. Survival for Adults Hodgkin lymphoma is now considered to be one of the most curable forms of cancer. Treatment Hodgkin lymphoma is often treated with radiation and chemotherapy. Incidence in Adults The incidence of non-Hodgkin lymphoma increases with age. followed closely by Hispanic children of all races (24. Lymphomas (Hodgkin lymphoma.000 persons at ages 80 to 84.070 from Hodgkin lymphoma). troublesome itching and weight loss.400 children under the age of 15 will be diagnosed with cancer in 2007. five-year relative survival for non-Hodgkin lymphoma is now 83. 1. the highest incidence of non-Hodgkin lymphoma is in Asian/Pacific islanders. About 2. comprising nearly 5 percent of all cancers diagnosed. the highest incidence of non-Hodgkin lymphoma is in non-Hispanic whites. In the United States. excessive tiredness. Non-Hodgkin lymphoma is the ninth most common cause of cancer death in males and the seventh in females in the United States. groin or in the abdomen. Incidence in Children The incidence of Hodgkin lymphoma among people under 20 years of age was 1. persistent fatigue.
4 3.600 10.0 0.Age-Specific Incidence Rates for Hodgkin Lymphoma. 2000-2004 110 100 90 80 Incidence (per 100. Epidemiology and End Results) Cancer Statistics Review 1975-2004.9 3.9 7. National Cancer Institute. Trends in Five-Year Relative Survival Rates by Race for Hodgkin Lymphoma and Non-Hodgkin Lymphoma Hodgkin Lymphoma All races Whites African-Americans 1975-77 1981-83 74% 74% 71% 76% 76% 73% 1990-92 1996-2003 83% 84% 74% 86% 87% 81% Estimated Deaths by Gender from Hodgkin Lymphoma and Non-Hodgkin Lymphoma Type Hodgkin lymphoma Non-Hodgkin lymphoma Total Overall 1.4 4. 2000-2004 6 Incidence (per 100. * <16 cases for time interval.0 45.1 102. 2007. Table 6: Source: SEER (Surveillance. 2007.9 1.4 15.0 1. Epidemiology and End Results) Cancer Statistics Review 1975-2004.4 80. 2007.0 20 10 0 0.0 100.360 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 2007.6 32.8 3.370 Female 300 9.1 0.8 2.8 112.8 4.5 10.4 2. National Cancer Institute.730 Male 770 9.6 0.5 <1* 1-4 5-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 Age in Years 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85+ Figure 8: Sources: SEER (Surveillance.660 19. National Cancer Institute.1 4.0 2.1 0.2 1.000) 5 4 3 2 1 0 0. Age-Specific Incidence Rates for Non-Hodgkin Lymphoma.3 4.1 3.3 <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 3. Epidemiology and End Results) Cancer Statistics Review 1975-2004.000) 70 60 50 40 30 22.9 4.4 2.060 9.070 18.4 2. 2007. *<16 cases per time interval. LEUKEMIA page 12 LYMPHOMA MYELOMA .2 4.1 3.1 63. American Cancer Society.4 2.
9 9.790 deaths from myeloma are anticipated this year. Age-Specific Incidence Rates for Myeloma.1 28.000) of myeloma than those of European descent (5.960 men and 8. has been increasing. National Cancer Institute.1 21. Treatment may include intensive chemotherapy followed by stem cell transplantation to restore normal blood cell production. 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.4 35.3 0. Deaths Approximately 10.000 to 3. SEER 17 areas (<1. The highest rates are found in black men 80 to 84 years of age and older (105/100. It grows continuously and forms masses of plasma cells. causing pain and crowding out normal blood cell production.5 3. 2007. Usually. especially in the marrow.1/100. Treatment is aimed at slowing progress of the disease. Fractures may occur as a result of the weakened bones.3/100. Recurrent infections may be an early sign of the disease.Myeloma Myeloma is a cancer of the plasma cells. Living with Myeloma An estimated 60. Lenalidomide is approved by the FDA in combination with dexamethasone for the treatment of myeloma patients who have received at least one prior therapy. Figure 9: Source: SEER (Surveillance. 1-4.000). Total survival for white males. From 2000 to 2004.7 1.900 (10. 20-24).8 14. Treatment Chemotherapy for myeloma has led to sustained remissions in some patients.5/100. approximately double. a type of white blood cell found in many tissues of the body. • The median age at diagnosis for African-Americans is 67. the cell that forms plasma cells. especially.000). The U.424 people in the United States are living with myeloma.000). destroying normal bone tissue.940 women) new cases of myeloma will be diagnosed in the United States in 2007. but primarily in the bone marrow. 2000-2004 Incidence (per 100. the patient’s own stem cells are used (autologous stem cell infusion). Myeloma was the 10th most common cause of cancer deaths for women in 2000-2004.0 37. Patients may have anemia.S. • Americans of African descent have a much higher incidence rate. Approximately 3 percent of all cancer-related deaths among AfricanAmericans in 2000-2004 were from myeloma. median age at death from multiple myeloma is 74. *<16 cases for each age interval. • The incidence rate in men (7/100. tire more easily and feel weak. 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. Sixty percent of those were diagnosed with the disease within the past four years. • The median age at diagnosis is 70. The onset of myeloma interferes with normal production of antibodies and makes myeloma patients susceptible to infections.5/100. In myeloma.000) 40 30 20 10 0 0-24 0. The mortality rate from myeloma for people of African descent is more than double the rate for whites (7. myeloma was the 10th most commonly diagnosed cancer among African-American men and women. a B lymphocyte.000) for all racial and ethnic groups. At times. LEUKEMIA LYMPHOMA MYELOMA page 13 . but it is the most difficult blood cancer to treat successfully. 5-9.1 5. Malignant plasma cells produce an abnormal protein called monoclonal immunoglobulin.1 Signs and Symptoms Often the first symptom of myeloma is bone pain caused by the effects of myeloma cells in the marrow. and it rarely occurs in people under age 45. Thalidomide is approved by the FDA for use in treating newly diagnosed myeloma. (11. 10-14. 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.000) is 56 percent higher than for women (4. New Cases An estimated 19. Bortezomib has been approved for treating myeloma in patients who have had at least two prior therapies. 15-19. two or three drugs are used simultaneously.4 33.2/100. becomes malignant. It is 71 for African-Americans.1 0. Epidemiology and End Results) Cancer Statistics Review 1975-2004.
000 Population (2000-2004) Type Leukemia Non-Hodgkin lymphoma Hodgkin lymphoma Myeloma Overall 10. per 100. for Blacks.2 2.) LEUKEMIA page 14 LYMPHOMA MYELOMA .3 19.5 Incidence Rates by Gender. for Whites.1 3.3 2. (Based on SEER 17 areas. Epidemiology and End Results) Cancer Statistics Review 1975-2004.000 Population (2000-2004) Type Leukemia Non-Hodgkin lymphoma Hodgkin lymphoma Myeloma Overall 12.7 24.6 2.5 Table 8: Source: SEER (Surveillance. (Based on SEER 17 areas. per 100.6 Female 9. 2007.7 5. per 100.5 16.2 14.000 Population (2000-2004) Type Leukemia Non-Hodgkin lymphoma Hodgkin lymphoma Myeloma Overall 12. Epidemiology and End Results) Cancer Statistics Review 1975-2004.6 4.1 2.Incidence Rates: Leukemia. National Cancer Institute.6 Male 16.2 3.1 11.0 Female 9.1 9.0 2.) Table 9: Source: SEER (Surveillance.9 2. All Races.3 Male 13.3 2.9 17.2 6. Lymphoma and Myeloma The following tables showing incidence rates for leukemia. (Based on SEER 17 areas. Hodgkin and non-Hodgkin lymphoma and myeloma use figures from 2000-2004.4 4.1 Table 10: Source: SEER (Surveillance. National Cancer Institute. 2007.8 20. the most recent available. Epidemiology and End Results) Cancer Statistics Review 1975-2004.8 14.4 11.9 5. Rates are per 100.2 18.0 Female 8.0 7.000 population and are age-adjusted to the 2000 population.2 Male 16.0 23. Incidence Rates by Gender. National Cancer Institute. 2007.) Incidence Rates by Gender.
240 170 550 130 800 3.680 920 340 890 170 290 330 190 1.S.150 290 270 70 * 1.370 250 280 2. Used with permission.Estimated New Cases of Blood Cancers by Site.410 560 * 740 230 230 930 70 300 50 350 1.520 310 3. model (see below). They cannot be compared with previous years’ estimates to determine cancer incidence trends. Note: These estimates are offered as a rough guide and should be interpreted with caution.160 1. Centers for Disease Control and Prevention.510 500 60 70 900 380 220 160 280 430 100 370 460 730 310 170 400 70 110 120 80 650 120 1.200 350 4.610 150 2.330 260 780 180 1.610 670 610 110 60 3.500 430 1. Used with permission. 2007 State Leukemia Non-Hodgkin Lymphoma Myeloma Hodgkin Lymphoma Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Dist.S.660 210 * 190 120 1.070 80 330 70 480 1.830 240 230 60 * 1. Table 12: Sources: Cancer Facts & Figures 2007. 1969-2004. 2007.160 140 50 360 440 170 320 * 18. 2006.030 570 * 610 210 360 1.390 1.560 770 890 3. *Estimate is fewer than 50 cases.710 570 500 2.010 1.070 Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Dist. The method of derivation. which is new for 2007.550 * * * * *20 * * * * 60 * * * 50 * * * * * * * * * * * * * * * * * * 70 * * 50 * * 60 * * * * 80 * * * * * * * 390 Table 11: Sources: Cancer Facts & Figures 2007.240 740 80 1.670 1.080 600 7. is described by Pickle et al. by State.140 60 260 80 410 1.310 800 600 900 920 330 1. **State estimates may not add up to U.630 540 80 120 990 510 310 230 320 330 100 390 490 770 400 210 460 80 150 160 100 680 120 1. numbers are small and NCI and ACS are having difficulty fitting them into the Pickle et al. 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 2.880 240 250 50 50 1.360 960 170 220 2. by State.180 4.070 110 1. total because of rounding and exclusion of estimates that are fewer than 50 cases. **State estimates may not add up to U.370 100 * 430 380 130 350 * 19. Note: These estimates are offered as a rough guide and should be interpreted with caution. National Center for Health Statistics. 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 4.410 130 50 500 490 130 490 * 21. 2007 State Leukemia Non-Hodgkin Lymphoma Myeloma Hodgkin Lymphoma*** Estimated Deaths from Blood Cancers by Site. ***Hodgkin lymphoma estimates are not available for 2007.130 300 80 900 960 300 1.S. 2007.260 220 400 420 290 2. and additional data supplied by the American Cancer Society.040 70 44. total because of rounding and exclusion of estimates that are fewer than 50 cases. Mortality Public Use Data Tapes.190 880 870 170 100 4.790 330 * 320 200 1.250 1.540 1. LEUKEMIA LYMPHOMA MYELOMA page 15 . and additional data supplied by the American Cancer Society based on data from the U.190 290 * 280 200 1.170 480 1.. American Cancer Society.550 2.360 610 * 950 290 260 1.300 110 63. CA A Cancer Journal for Clinicians. January/February 2007. Numbers are rounded to the nearest 10.080 1.140 380 140 1. American Cancer Society.530 1.300 470 90 100 750 430 300 220 290 310 110 320 420 660 350 170 500 80 110 130 90 600 120 1.050 140 140 * * 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. Numbers are rounded to the nearest 10. *Estimate is fewer than 50 cases.030 910 620 420 680 680 250 630 1.
survival and mortality have been revised. Epidemiology and End Results Program (SEER) regions (or. but these figures do not take into account differences in geography.. in comparison to the 2002 SEER report. if a person is initially diagnosed with melanoma and later develops leukemia.S. Definitions Incidence is the number of newly diagnosed cases for a specific cancer or for all cancers combined during a specific time period. no matter how long ago that diagnosis was. This year. race and ethnicity in various regions and region-specific health risks. state-by-state data for incidence of Hodgkin lymphoma are not available because these numbers are so small. When expressed as a rate. LEUKEMIA page 16 LYMPHOMA MYELOMA . The data can be extrapolated for the entire United States by multiplying by the population ratio.S. prevalence numbers reported may vary depending upon the method used to determine them. This change means that the 2007 incidence estimates are not comparable with previous estimates for determining cancer incidence trends. The description of the methods used was published in Pickle et al. (Observed survival is the actual percentage of patients still alive at some specified time after diagnosis of cancer. his or her survival with leukemia may not be counted in leukemia prevalence statistics. may be incomplete in some cases and the data may reflect adjustments that anticipate changes that will occur once the actual data are received. so the exact number of cases is not known. Census. Thus. 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. estimates of cancer incidence. the American Cancer Society changed its method of estimating cancer incidence.) Prevalence is the estimated number of people alive on a certain date in a population who previously had a diagnosis of the disease. 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. The SEER (17 region) data cover only about 26 percent of the U. based on the “first invasive tumor for each cancer site diagnosed during the previous 29 years (1975-2003). The specified date is 1/1/2004 for the prevalence estimates. race or sex. January/February 2007. In this report. especially in looking at populations in which individuals have had more than one type of cancer. It considers deaths from all causes. the data presented in the 2007 SEER report placed online on April 15. Because of reporting delays from some of the SEER regions. it is the number of new cases per standard unit of population during the time period. Mortality data reflected in the 2007 SEER report used as a reference reflect data updates from the National Center for Health Statistics from 1975 to 2004.Notes and Definitions Notes The United States does not have a nationwide reporting system or registry for blood cancers. only the first diagnosed cancer counts.S. Relative survival rate is an estimate of the percentage of patients who would be expected to survive the effects of the cancer. mostly upward. 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. Thus. It includes new (incidence) and preexisting cases and is a function of both past incidence and survival.” We are using the “29-year limited duration” prevalence figures. 2007. cancer or otherwise.” as per SEER table I-21. Because of changes in the information — such as racial classification — gathered in the 2000 U. CA A Cancer Journal for Clinicians. population. Bureau of the Census’ 2000 population data for that region. 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. Incidence rates can be calculated based on a number of factors such as age. Because of this change in method. in some cases fewer than 17 SEER regions) and death data from the National Center for Health Statistics. Prevalence may be calculated in a number of different ways.S. The data presented in this report are an extrapolation or estimate of the number of cases reported by the 17 Surveillance. These numbers are extrapolated to the entire 17 SEER regions by dividing the number of cancer cases or deaths in a specific region by the U. population) that belong to the National Program of Cancer Registries. The relative survival rate is a comparison of survival to a person who is free of the disease. In some prevalence statistics.
CA A Cancer Journal for Clinicians Vol. Reichman M. pp. Howe HL. 2007. Cancer Facts & Figures for African Americans 2007-2008. “Lymphomas and Reticuloendothelial Neoplasms. 39-51. and End Results (SEER) Program. “A New Method of Estimating United States and State-Level Cancer Incidence Counts for the Current Calendar Year. 2006. 065767. http://www. MD. Epidemiology. and End Results) Cancer Statistics Review. “Leukemias. Hao Y. p. In Cancer Epidemiology in Older Adolescents and Young Adults 15 to 29 Years of Age.com/cgi/content/full/12/1/20. Barr R. NIH Pub. Feuer EJ. 1975-2004. posted to the SEER Web site 2007. Ries LAG. Epidemiology. Miller BA. Ross J. Bethesda. 30-42. Howlader N. Hachey M. Ries LAG (eds). Mariotto A. The Oncologist Vol. Atlanta: American Cancer Society. January. Howlander N. MD. National Cancer Institute.” Bleyer A. MD. NIH Pub. Shu X-O. O’Leary M. Edwards BK. O’Leary M. MD. based on November 2006 SEER data submission. 57.cancer. Atlanta: American Cancer Society.Citations Source Citations Cancer Facts & Figures 2007. 06-5767. http://seer. pp. National Cancer Institute.” Mattano L Jr.” Pickle LW.amcancersoc. SEER (Surveillance. pp. NIH Pub. 2007. Ward E. 065767. No. In Cancer Epidemiology in Older Adolescents and Young Adults 15 to 29 Years of Age. Including SEER Incidence and Survival: 1975-2000. 174. and Multiple Primary Cancer Analyses from the Surveillance. Nachman J. pp. In Cancer Epidemiology in Older Adolescents and Young Adults 15 to 29 Years of Age. http://caonline. “Highlights and Challenges. 2007. Ries LAG (eds). Krapcho M. Sheaffer J. Feuer EJ. 2006. Reichman ME. Melbert D. Cheson B. Bleyer A. National Cancer Institute.org/cgi/content/full/57/1/30. Ries LAG (eds). National Cancer Institute. O’Leary M. Horner MJ. January/February. Barr R. Bleyer A. 25-38. Eisner MP.” Hayat MJ. Barr R. Zou Z. Keller F. 20-37. Bleyer A. 2007. Stock W.gov/csr/1975_2004/ LEUKEMIA LYMPHOMA MYELOMA page 17 . Barr R. No. “Cancer Statistics. Including SEER Incidence and Survival: 1975-2000. Bethesda. Jemal A. Bethesda. 12.” O’Leary M. No. Trends. Including SEER Incidence and Survival: 1975-2000. Tiwari RC. Clegg L. Bethesda. Edwards BK (eds).TheOncologist. 2006.
Each SCOR is funded up to $1.6 million annually on research. the Society’s grant programs are among the most prestigious in the fields of blood cancers.000 over five years. diagnosis or prevention in the near term. lymphoma and myeloma.000 a year for a total of $150.000 over three years. each focused on the discovery of new approaches to benefit patients or those at risk for developing leukemia. They are: 1) Career Development Program (CDP)-basic research. The program is expected to generate new knowledge and breakthrough discoveries. The Specialized Center of Research (SCOR) in Leukemia. • Special Fellows in Clinical Research are awarded $60. The Society is a nonprofit organization that relies on the generosity of individual and corporate contributions to advance its mission. We offer a wide variety of programs and services in support of our mission: Cure leukemia.25 million.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.000 over three years. and improve the quality of life of patients and their families. The participating scientists may be at different institutions or from any country.000 over five years. Thus. Career Development Program The Career Development Program supports promising young scientists (Scholars. Since the first funding in 1954. research reaching a clinical trial can receive $1 million over five years to facilitate new drug discovery or advances in diagnosis or prevention. or control of. to a total cost of $6. lymphoma and myeloma that is intended to advance treatment. lymphoma or myeloma. Awards go to those groups that best demonstrate the synergy that will occur from their close interaction. 2) CDP-clinical research. lymphoma and myeloma should be encouraged worldwide.000 per year for three years.000 a year for a total of $550. Translational Research • Scholars in Clinical Research are awarded $110. the Society has awarded more than $550 million in research grants. The SCOR grants also support scientific core laboratories to provide access to innovative technology if required by the participating research programs. Translational Research Program The Translational Research Program provides early-stage support for research on leukemia. The SCOR program brings together research teams working in complementary areas. 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 . Now supporting $61.000 a year for a total of $550. leading to better survival rates and prevention measures for patients.000 a year for a total of $180. • Fellows are awarded $50. Research Research Grant Programs The Society’s research programs are based on the belief that all scientifically sound approaches toward a cure for. treatment or prevention of leukemia. Awards up to $200. 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 Awards are made for an initial three-year period. lymphoma and myeloma research comprise four review subcomittees. • Special Fellows are awarded $60. Translational Research and the Specialized Center of Research (SCOR). for a total of $600. Hodgkin’s disease and myeloma. 3) Translational Research Program.000 over three years.25 million per year over a five-year period. are granted each year.000. leukemia. Research grants are awarded in three program areas: Career Development. lymphoma. Funding for two additional years may be provided for highly promising projects that are entering phase I clinical trial.000 a year for a total of $180. 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.
m. brochures and videos through the IRC and local Society chapters. Much of the content of these materials is available to view and download at www. and click “Live Help. lymphoma. Teleconferences and Webcasts The Society sponsors more than 25 educational teleconferences and Webcasts each year on topics of interest to patients and caregivers. www.LLS. is held each December on the Friday immediately before the American Society of Hematology meeting. The Society funds several Focused Workshops each year on important topics relevant to hematological malignancies. myeloma and MDS who have difficulty paying for or simply cannot afford their health insurance premiums or prescription drug co-pays can now apply for assistance from the Society. The Annual Research Symposium. information about our peer-to-peer program First Connection and other programs. 2007 the Society will have 379 active grantees at 116 institutions in the United States and abroad. 9 a. These offices conduct lifeenhancing patient services.org or faxing to (914) 949-6691 or contacting the Research Department at (914) 949-5213.m.LLS. each group provides information and support.org/copay.LLS. podcasts and Webcast archives of these programs are available at www. audio. peer counseling and patient financial aid.org. sponsored by the Society.LLS.m. Patients. on the Society’s Web site. A trained patient volunteer currently in remission phones the new patient to share information and support. Information Resource Center (IRC) The Society strives to be the world’s foremost source of information on leukemia. You may also chat online with an information specialist. ET. ET.m. from 10:00 a.org. The educational program offers varying formats to facilitate the exchange of information and ideas on the newest developments in cancer research and treatment. to 5:00 p. Family Support Group locations.LLS. Monday through Friday.org. Professional Education The Society serves the continuing educational needs of the medical and research community through professional symposia offered throughout the year. Educational Materials An extensive collection of free educational materials are offered to patients and health professionals. The Society also hosts numerous teleconferences and Webcasts. Information specialists are oncology social workers and health educators who provide callers with current information on blood cancers. the Translational Research Grant Progress Review Meeting and the SCOR Progress Review Meeting.org. families and professionals may call the IRC toll free at (800) 955-4572 in addition to corresponding by email at infocenter@LLS. to 6 p. clinical trials and offer guidance on coping. Patient Services The Society has a network of 68 chapters throughout the United States and Canada.org. lymphoma. The site features a comprehensive overview of blood cancers. Each year. The IRC is a worldwide link to information and resources useful to patients. LEUKEMIA LYMPHOMA MYELOMA page 19 . They are available to talk one-onone. families.org. These include the Stohlman Scholar Symposium. www. myelodysplastic syndromes (MDS) and other blood cancers. their families and healthcare professionals. and applications for the Society’s three research programs may be obtained by visiting www. Other meetings are held for the Society’s grantees. lymphoma and myeloma. First Connection: This program links newly diagnosed patients to a peer volunteer who has experienced a similar diagnosis. The user has the opportunity to create personalized pages with identified interests. treatments. including support groups. It is continually being updated and expanded to support and promote the Society’s mission. The Society’s Web Site The Society’s Web site.” Chapter Programs: Family Support Groups: The Society has developed more than 360 Family Support Groups at 68 chapters. This support should advance the understanding. Co-Pay Assistance Program Patients with AML. Information on registration for these free events can be accessed at www.LLS. Patients needing assistance may apply on the Society’s Web site.LLS.org. call (877) LLS-COPAY ( 557-2672) or email copay@LLS. Guided by two volunteer oncology health professionals. www. where medical professionals share the latest research findings.org or by or emailing researchprograms@LLS. Guidelines. the Society’s programs and services.important projects to advance the Society’s mission. the Society distributes more than 1 million booklets. treatment and prevention of leukemia. myeloma. As of June 30. instructions. friends and healthcare professionals. serves a wide variety of education and information needs. and encourages greater communication among patients.
drugs and various treatments not covered by insurance. In 2001. reimbursement of up to $500 per year helps cover the costs of transportation. The Society has identified key issues that currently shape its advocacy agenda. Advocacy Since 1994. the Society successfully lobbied Congress to institute a blood cancer research initiative as part of the U. Printed literature. Through the Patient Financial Aid Program. the Society’s advocacy program has been a strong voice in Washington. 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. the Society has helped patients demonstrating a need for financial assistance cover a portion of their treatment costs.org and is being sponsored by a generous.S. This nursing education program provides an overview of CML. treatments. To date. lymphoma and myeloma. Patient financial aid funds are subject to availability. It is supported by Amgen Oncology. This program is being sponsored by an unrestricted education grant from Novartis Oncology. The patient education program was funded at $18 million through 2007. The Trish Greene Back to School Program for Children with Cancer: This program is designed to increase communication among healthcare professionals. 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. staging and classification of nonHodgkin lymphoma (NHL).and long-term effects that children may experience after treatment. New Directions in Myeloma Therapy: This program presents an overview of myeloma. families and healthcare professionals with a clear description of what clinical trials are. how cancer drugs are developed and what the emerging treatment options are for leukemia.000 and has become a potent voice in public policy deliberations. that program has funded some $30 million in additional blood cancer research. Meet the Expert on Non-Hodgkin Lymphoma: This program presents basic information on terminology. Society volunteers and staff visit Capitol Hill regularly to lobby Congress in support of issues that impact research and patient care. videos and other materials to aid the process are available through all local chapters. This program is provided through an unrestricted educational grant from Millennium Pharmaceuticals. this education program discusses possible emotional and cognitive short. diagnosis. emerging therapies and side effects and addresses the unique challenges of nursing management of these patients. patients and school personnel to assure youngsters a smooth transition from active treatment back to school. In 2002. and offers numerous resources that can assist childhood cancer survivors to flourish in the school environment posttreatment. That network now numbers more than 35. 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.Patient Financial Aid Program: For more than 31 years. This program is also accessible as a Webcast at www. treatments and future directions for NHL are also discussed. DC. Department of Defense’s medical research program. CML Issues and Insights: A Nursing Education Program on Chronic Myelogenous Leukemia. This Society program is being supported by Celgene Corporation and Millennium Pharmaceuticals. Welcome Back: Facilitating the Return to School for Children with Cancer: A new addition to The Trish Greene Back to School Program. On the state level. 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. New insights. The Path to Progress: Clinical Trials in Blood Cancers: This program provides patients. representing to policy makers at all levels of government the healthcare quality concerns and medical research interests of patients and their families. providing additional support for blood cancer patients and their families nationwide. parents. unrestricted educational grant from Genentech BioOncology and Biogen Idec Inc.LLS. 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. Working through chapters across the country. risk factors. This program is made possible by the Lance Armstrong Foundation. LEUKEMIA page 20 LYMPHOMA MYELOMA . emerging therapies and managing side effects and how to find emotional support when living with the illness.
for compilation of data for this publication. of the American Cancer Society (ACS). provided ACS’s state-by-state statistics on myeloma and Hodgkin lymphoma.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. It is distributed as a public service by The Leukemia & Lymphoma Society Inc..cancer.seer. The Leukemia & Lymphoma Society extends special thanks to Myrna Watanabe. NCI.D. Ph. provided statistical assistance. This publication is designed to provide information in regard to the subject matter covered. and Rebecca Siegel. Milton Eisner of SEER. .gov.
Hodgkin’s disease and myeloma.LLS.HELP.org Our mission: Cure leukemia.Home Office 1311 Mamaroneck Avenue. lymphoma. PS80 35M 6/07 . and improve the quality of life of patients and their families. corporate and foundation contributions to advance its mission.LLS Information Resource Center (IRC): 800.955.4572 www. New York 10605 Tel: 888. The Society is a nonprofit organization that relies on the generosity of individual. Suite 310 White Plains.