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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.
1998. 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. nonacute myelogenous and monocytic leukemias Lymphoma: • There are 544. 10. which becomes malignant and multiplies continuously. • Every 10 minutes. Oxford University Press. 1996. 63. *except acute myelogenous leukemia (AML) and other. National Cancer Institute.920 new cancer cases diagnosed in the United States this year. • Eighty-six percent of myeloma cases occur in people aged 55 and over. • Thirty-two percent more males are living with leukemia than females.380 new cases of lymphoma will be diagnosed in the United States (8. 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 218.240 people will be diagnosed with leukemia. 2007 and SEER 19731993. Leukemia. The data within Facts 2007-2008 reflect the most recent statistics available from SEER.349 Americans are living with leukemia.190 cases of Hodgkin.444. 2nd Edition. • These blood cancers will account for 9. 44. 19. From 1975 to 2004. and myeloma.266 people living today with lymphoma. The next SEER Cancer Statistics Review is expected to be published online in April 2008. is a compilation of the most recent data on leukemia. Epidemiology and End Results Program.730 people will die from lymphoma (1.gov.424 people living today with myeloma. lymphoma and myeloma in 2007. page 16). or nearly six people every hour.953 either have or are in remission from non-Hodgkin lymphoma (NHL). the National Cancer Institute’s Surveillance. in April 2007.cancer. Myeloma: • • • • There are 60.seer. www. Cancer Statistics Review 1975-2004 (see Notes.790 people will die from myeloma. National Cancer Institute.790 people will die of leukemia. 1975-2004.190 cases of non-Hodgkin). • New cases of leukemia. This year. Survival • An estimated 823. lymphoma and myeloma will cause the deaths of an estimated 52. 1960-1963 1975-1977 1996-2003 Figure 1: Sources: SEER (Surveillance. Highlights from the Report Include: New Cases • An estimated 135. • This year. 405. an annual publication. This statistic represents 143 people each day. and its age-adjusted incidence rose by nearly 84 percent from 1975 to 2004. • In 2007. • Leukemia causes more deaths than any other cancer among children and young adults under the age of 20.650 total cancer-related deaths.4 percent of the 1.3 percent of the deaths from cancer in 2007 based on the 559. Hodgkin and non-Hodgkin lymphoma. someone is diagnosed with a blood cancer. Epidemiology and End Results) Cancer Statistics Review. *Myeloma Biology and Management. LEUKEMIA LYMPHOMA MYELOMA page 1 . These data were published online by SEER. 18. Five-Year Relative Survival Rates 1960-1963 vs. the likelihood of dying from most leukemias*. • Non-Hodgkin lymphoma is the fifth most common cancer in the United States.1975-1977 vs. Hodgkin and non-Hodgkin lymphoma and myeloma will account for nearly 9.Executive Summary Facts 2007-2008. More males are diagnosed with leukemia and more males die of it than females. • In general. • This year. Deaths • Leukemia.310 people in the United States this year.313 either have or are in remission from Hodgkin lymphoma. 71. lymphoma and myeloma. 19. • Every five minutes. Mortality from the disease increased 24 percent. • In 2007. This year.660 from non-Hodgkin). lymphoma and myeloma decreased from 1995 to 2004 (the last year data were available).070 from Hodgkin. 21.900 people will be diagnosed with myeloma.520 people in the United States will be diagnosed with leukemia. 138.659 people in the United States who are either living with or are in remission from leukemia. the incidence of myeloma increased 8 percent. someone dies from a blood cancer. This abnormal accumulation interferes with the production of healthy blood cells.
These diseases usually result from an acquired genetic injury to the DNA of a single cell. usually in combinations of two or more drugs. 2007. 2007. (Numbers do not add up to 100% because of rounding. The harvesting. There are two major types of stem cell transplants: syngeneic and allogeneic. is largely responsible for the dramatic improvement in managing leukemia and lymphoma. for which a parent rather than a sibling could be the donor. decreased ability to fight infections and a predisposition to bleeding. Patients with acute lymphocytic leukemia (ALL). especially for 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. especially in young children. Hodgkin and non-Hodgkin lymphoma and myeloma are cancers that originate in a cell in the bone marrow or lymphatic tissues. 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. The blood or marrow stem cells are collected while the patient is in remission.) of larger adult patients. usually a brother or sister with the same tissue type. The accumulation of malignant cells interferes with the body’s production of normal blood or immune cells and can result in severe anemia. American Cancer Society. An allogeneic transplant uses blood or marrow stem cells from a normal donor. The technique of harvesting stem cells from blood and cord blood has made transplantation available for more LEUKEMIA page 2 LYMPHOMA MYELOMA . The technique is important. studies suggest that two matched cord donors may result in a higher success rate in larger adults. Syngeneic transplant describes the use of an identical twin as donor. slightly mismatched cord stem cell donors may be used quite successfully. some types of Hodgkin lymphoma. The stem cells are frozen and later they can be thawed and infused into the patient if intensive chemotherapy and/or radiotherapy is required for subsequent treatment. In special instances. Research is being conducted to improve socalled “haploidentical” transplant. If a sibling is not available. which becomes abnormal (malignant) and multiplies continuously. The numbers of stem cells in cord blood are often insufficient for the needs Figure 2: Source: Cancer Facts & Figures. 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. Autologous transplantation uses the patient’s own marrow stem cells and is technically not transplantation since another person is not the donor. a search of the National Marrow Donor Program registry of tissue-typed volunteers could be made for a matched unrelated donor. Such an approach would greatly lessen the proportion of children without a donor. myeloma and lymphoma are usually treated with chemotherapy. freezing and storing of cord blood have provided another source of stem cells for transplantation. Patients with leukemia. Estimated New Cases (%) of Blood Cancers in 2007 Myeloma 15% Leukemia 33% Lymphoma 53% Treatment Chemotherapy and Radiotherapy: The use of chemotherapy (anticancer drugs). 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.About the Diseases Leukemia. lymphoma and myeloma. However. They are considered to be related cancers because they arise from cells with a common origin (the lymphohematopoietic stem cells) and with related functions. Stem cells also circulate in large numbers in fetal blood and can be recovered from umbilical cord and placental blood after childbirth. Approximately 50 different drugs are now being used in the treatment of these diseases.
Coordination between specialists and primary care physicians is essential to provide the best care possible. 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. Over time. Follow-Up Guidelines: The Children’s Oncology Group has established Long-Term Follow-Up Guidelines for Survivors of Childhood. but some follow adult cancer survivors. 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. the donor’s cells take hold and the patient’s leukemia. Regular examinations may include screening for cancer recurrence or the development of secondary cancer or other late effects of treatment. decreased side effects. Cancer survivors should have physical examinations yearly or more often. the recipient’s blood cell and immune system are preserved. In nonablative transplantation. Adolescent. Imatinib mesylate (Gleevec®) is now the drug of choice in newly diagnosed patients with chronic myelogenous leukemia (CML). lymphoma and myeloma. Stem cells not only reside in the marrow but also circulate in the blood. these cells can be harvested from the blood of a donor. identify recurrence of the disease and detect long-term or late effects. thereby allowing doctors to plan treatment accordingly. The effectiveness and tolerance of older patients and the projections from the first five years of clinical trials in newly diagnosed patients suggest that the drug will prolong the duration of hematological remission and life when compared to former therapy. This “graft versus leukemia or lymphoma effect” can suppress (cure) the malignancy and is a prolonged (indefinite) form of immunotherapy. lymphoma or myeloma is attacked and suppressed by donor lymphocytes that form from the donor stem cells. New Approaches to Treatment Several areas of research have resulted in new approaches to the treatment of leukemia. several important new drugs and new uses for existing drugs have greatly improved cure rates or remission duration for some patients with leukemia. In standard stem cell transplantation. Blood and cord blood transplants differ from marrow transplants principally in the source of the cells collected for transplant. lymphoma or myeloma and permit the donor’s cells to be accepted by the temporarily immunodeficient recipient. few severe adverse effects on normal tissues and a very high response rate. Identifying these biomarkers will allow researchers to develop tests that can predict what effects an individual is at risk of developing. Cancer survivors should see their primary care physicians for general health examinations and an oncologist for follow-up care related to cancer. “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. This still experimental approach greatly lessens the early toxicity of transplantation and has extended the age at which recipients with leukemia. donors of blood stem cells require special treatment to mobilize sufficient stem cells from marrow into their blood before cells are harvested. Cancers (http://www. Some treatment centers have follow-up clinics that provide a comprehensive. making the procedure more tolerable. 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. two second-generation agents. 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. Although a minority of patients have developed resistance to the drug. as needed. as well as marrow. ablation of the recipient’s blood-cell forming and immune cells was the price that had to be paid to eradicate the leukemia.childrensoncologygroup. Predictive tests: Research is under way to identify biomarkers that may indicate a higher-than-normal risk of developing a specific long-term or late effect. Gleevec offers several dramatic advantages to patients: oral administration. The protein is an enzyme in the family of tyrosine kinases. multi-disciplinary approach to monitoring and supporting cancer survivors. and Young Adult LEUKEMIA LYMPHOMA MYELOMA page 3 . Most follow-up clinics specialize in pediatric cancer survivors.org/). lymphoma or myeloma can have an allogeneic transplant. To ensure there will be enough blood stem cells for successful transplantation. is a source of stem cells for transplantation. frozen and stored and later transplanted in the patient. marrow and immune system. “Ablation” referred to wipingout the recipient’s cancer. Because blood.patients. Development of New Drugs: In the past decade.
Other therapies in clinical research to treat MDS include arsenic trixoxide. Cell surface antigens have been given a cluster designation (CD) followed by a number. a less common type of chronic lymphocytic leukemia (CLL). Gleevec is not only a very important new agent in the treatment of CML. 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 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. cyclophosphamide. the most prevalent lymphoma subtype. approved by the FDA for all types of MDS. is being used to treat relapsed or refractory acute lymphocytic leukemia (ALL) in children who have received at least two prior therapies. although initially used in indolent lymphomas. are entering clinical use and can overcome this resistance in some cases. Lenalidomide (Revlimid®). Early studies indicate the combination of arsenic trioxide and all-trans retinoic acid may be a further advance in the initiation of therapy. Three types of immunotherapy are being explored: antibody treatment. and Decitabine (Dacogen®). thus rituximab is an anti-CD20 antibody. LEUKEMIA page 4 LYMPHOMA MYELOMA . 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. and enhances the specificity of treatment to minimize toxic effects on normal tissues. This drug is also being tested in clinical trials to treat adult acute leukemia and MDS. approved by the FDA in 2005. a thalidomide derivative. Rituximab is an antibody directed at the target CD20 antigen on B-cell lymphoma cells. It is especially active against the lymphocytes in CLL. 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®). 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. has improved dramatically with the introduction of cladribine. chronic eosinophilic leukemia (formerly hypereosinophilic syndrome). lymphoma or myeloma. however. principally. vincristine (Oncovin®) and prednisone–therapy for diffuse large B-cell lymphoma. 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). but it can also induce remissions in some cases of acute leukemia. has been approved by the FDA for the treatment of a specific type of myelodysplastic syndrome (MDS) that results from an alteration in chromosome 5. Revlimid is approved by the FDA in combination with dexamethasone for the treatment of myeloma patients who have received at least one prior therapy. Patients with more severe forms of MDS are very unlikely to respond to the agent. suppresses the progression of leukemia.dasatinib (Sprycel®)(approved by the U. was approved by the FDA for newly diagnosed myeloma. Alemtuzumab (Campath®) is a monoclonal antibody directed against the antigen CD52 found on T and B lymphocytes. PDGFR or KIT oncoproteins). such as follicular lymphoma. Clofarabine (Clolar®). Cladribine induces long-term remissions in nearly 90 percent of patients treated at diagnosis for one week. doxorubicin (Adriamycin®). immune cell administration and vaccine development. symptomatic anemia have improvement in hemoglobin levels with this agent. reducing the need for transfusions in some patients. Azacitidine (Vidaza®). Food and Drug Administration [FDA] in 2006) and nilotinib (in clinical trials). thalidomide (Thalomid®). 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. it has now become an important fifth drug in the R-CHOP–rituximab. Monoclonal antibodies have added to the arsenal of agents that are used for the treatment of patients with lymphoma and leukemia. Rituximab has become an important agent to treat CD20-positive lymphocytic malignancies. Immunotherapy: This is a treatment that uses immune cells or antibodies to fight the disease. perhaps 20 percent of cases also derive benefit. Some patients with moderately severe. Velcade is approved by the FDA for treating people with myeloma who have had at least one prior therapy. In May 2006. in combination with dexamethasone. Pentostatin is another effective drug that can be used in patients with hairy cell leukemia who do not respond to cladribine.S. In patients with anemia. The treatment of hairy cell leukemia. Arsenic trioxide also adds to the drugs available to treat this subtype of acute leukemia.
Paradoxically. Reversal of Multidrug Resistance: The malignant cells of patients have mechanisms that may allow them to escape the damaging effects of chemotherapy agents. lymphoma and myeloma. 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. They deliver the toxic substance directly to the cancer cells. 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. the patient’s immune cells would be treated in the laboratory to train them to attack the residual leukemia. This means that the vaccine induces an immune response against the cancer cells present in the patient. 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. DNA vaccines that contain the DNA that encodes the specific antigen are being tested. In studies of CML. Approaches to reversing multidrug resistance are under study.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. LEUKEMIA LYMPHOMA MYELOMA page 5 . lymphoma or myeloma cells. In one approach. gene therapy researchers are trying to modify an oncogene (BCR-ABL) that produces a protein that stimulates malignant cell growth. These types of vaccines would be used in patients who have small amounts of residual blood cancer after chemotherapy or stem cell transplantation. cells are isolated in the laboratory and start making antibodies after insertion of the cancer antigen. 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. The goal is to extend the duration of remission achieved by remissioninduction therapy of various types. In each case. some vaccines are made from leukemic cells treated in test tubes to convert them to potent antigen-presenting cells. 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. myeloma and leukemia. In patients with CML who have relapsed after stem cell transplantation. An alternative strategy called molecular targeted drug development targets the oncoprotein. Two new and potentially important approaches include a) the application of RNA interference. a technique that prepares small molecules in the laboratory that have the ability to inactivate proteins that cause disease. In some approaches. These cells are. Vaccines: Experimental treatment vaccines are now being studied to treat certain types of lymphoma. the infusion of the original marrow donor’s lymphocytes can re-induce remission. This type of treatment is being studied intensively to learn more about the basis for this immune cell effect and to expand it for use in other situations. Studies of vaccines used in patients with follicular or indolent lymphoma have demonstrated an immune response. These drugs have been approved to treat relapsed B-cell non-Hodgkin lymphoma. b) a modality that uses molecules of RNA to silence complementary (DNA) genes. 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. new forms of cancer therapy may be developed. Patients with myeloma have also had remission re-induced by donor lymphocytes. gemtuzumab (Mylotarg®). These are called conjugated monoclonal antibodies. This drug. or become. Vaccines are in clinical trials for types of acute and chronic leukemia. Examples of this treatment are the drugs ibritumomab (Zevalin®) and tositumomab and iodine I131 tositumomab (Bexxar®). drugs are designed to interfere with the oncoprotein and prevent its effect on the cell. is approved for older patients with AML who relapse after initial treatment. less responsive to therapy. If the gene in the former case is an oncogene or the protein in the latter case is an oncoprotein. and aptamer treatment. In another approach. The goal of several new agents being studied is to decrease resistance to an important chemotherapy drug used in leukemia. Monoclonal antibodies can also be linked to a radioactive isotope to target and kill specific cancer cells.
It is characterized by the uncontrolled accumulation of blood cells.570 19.289 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. functionless cells in the marrow and blood.659 people in the United States are living with leukemia. and End Results) Cancer Statistics Review 1975-2004. Chronic leukemias account for 7 percent more of the cases than acute leukemias. Leukemia is divided into four categories: myelogenous or lymphocytic. American Cancer Society. National Cancer Institute. develops in virtually all leukemia patients. In 2007.060 2. DCCPS.Leukemia Leukemia is a malignant disease (cancer) of the bone marrow and blood. Nearly 54 percent of the new cases of this disease will occur among children in 2007 (about 2. The terms myelogenous or lymphocytic denote the cell type involved. Anemia. 1. The marrow often no longer produces enough normal platelets. 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 218.350 2.960 7. Surveillance Research Program. Approximate U.570 5. Epidemiology. Prevalence of the Four Major Leukemias as of Jan.440 Table 2: Sources: SEER (Surveillance. Only 2. and SEER Program. Leukemia is expected to strike more than 10 times as many adults as children in 2007.200 15. released April 2007. The lack of normal white cells impairs the body’s ability to fight infections. New Cases An estimated 44.060 8.150 24. *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.189 27. • Most cases of leukemia occur in older adults. The four major types of leukemia are shown in Table 1. males are expected to account for 56 percent of the new cases of leukemia. • The most common form of leukemia in children is acute lymphocytic leukemia (ALL). each of which can be acute or chronic.570 3. functional cells to be made.140 6.800 children. A shortage of platelets results in bruising and easy bleeding.240 Male 3. (About 40.240 new cases of leukemia will be diagnosed in the United States this year. Chronic leukemia progresses more slowly and allows greater numbers of more mature. 2007.000 2. based on the November 2006 SEER data submission.720 44.S. 2004 Type Chronic lymphocytic leukemia Chronic myelogenous leukemia Acute lymphocytic leukemia Acute myelogenous leukemia Prevalence* 95. Table 3: Source: Cancer Facts & Figures 2007. a deficiency of red cells. 2007.790). Incidence by Gender Incidence rates* for all types of leukemia are higher among males than among females.340 13.440 adults compared with 3. NCI. Statistical Research and Applications Branch. LEUKEMIA page 6 LYMPHOMA MYELOMA . Prevalence database: U.S.4 percent of leukemias in children aged 0-19 are CML. • About 33 percent of cancers in children aged 0-14 years are leukemia • Most cases of chronic myelogenous leukemia (CML) occur in adults.410 4.800 Female 2.380 6.000 population. Estimated 29-Year L-D Prevalence Counts on 1/1/2004 by Duration.579 21. more than half of all cases occur after age 67.501 50. aged 0-19. *Note: Incidence rates are the number of new cases in a given year not counting the preexisting cases. The incidence rates are usually presented as a specific number per 100. Acute leukemia is a rapidly progressing disease that results in the accumulation of immature. red blood cells and white blood cells.) • The most common types of leukemia in adults are acute myelogenous leukemia (AML) and chronic lymphocytic leukemia (CLL).
leukemia rates are higher in Americans of European descent than among those of African descent. Leukemia strikes all ages and both sexes. Leukemia rates are substantially higher for Hispanic. American Indian/Alaskan natives. Adolescents and Young Adults. Among 15. The most common form of leukemia among children under 20 years of age is ALL. The incidence of ALL among 1. neither explains most cases.619 with ALL.to 4-year-old children is more than nine times greater than the rate for young adults ages 20 to 24. Leukemia is one of the top 15 most frequently occurring cancers in minority groups. They do warrant medical evaluation. Figure 3: Source: Cancer Facts & Figures 2007. white and Asian/Pacific islander children than for black children. Adults. The incidence rate for all cancers among AfricanAmericans in the Seer (17 region). 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. CLL incidence increases dramatically among people who are aged 50 and older. These signs are not specific to leukemia and may be caused by other disorders.799 children under the age of 20 diagnosed with leukemia from 2001-2004. From 1975 to 2000. eighth and ninth decades of life. the incidence of AML slowly rose while that of ALL steadily decreased in the period from late adolescence to older adulthood. American Cancer Society. CML incidence also increases dramatically among people who are aged 60 and older. 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. However. Children. In 25. The cause of leukemia is not known. including 3. Incidence by Race and Ethnicity Incidence rates for all types of cancer combined are more than 5 percent higher among Americans of African descent than among those of European descent. About 2.to 19-year olds. 2007.800 children will be diagnosed with leukemia throughout the United States. averaging about 189.Estimated Proportion of New Cases (%) in 2007 for Each Type of Leukemia Including Adults and Children 3. Leukemia incidence is highest among whites and lowest among American Indians/Alaskan natives. Although chronic exposure to benzene in the workplace and exposure to extraordinary doses of irradiation can be causes of the disease. Most children under 15 years of age with ALL are cured. In the 17 SEER regions of the United States.000 population.5 times that of ALL. and AML incidence increases dramatically in people who are aged 60 and older. The diagnosis of leukemia requires specific blood tests. The American Cancer Society estimates that there will be approximately 152. there were 4. It is estimated that in 2007. was 504 per 100. The leukemias represented 27 percent of all cancers occurring among children younger than 20 years from 2000-2004. LEUKEMIA LYMPHOMA MYELOMA page 7 .to 29-year olds. from 2000-2004. AML incidence was approximately 1. These cancers are most prevalent in the seventh. Hispanic children of all races under the age of 20 have the highest rates of leukemia. 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).900 new cases of cancer diagnosed in African-Americans in 2007.922 cases per year. Incidence by Age-Group Incidence rates by age differ for each of the leukemias. Possible Causes of Leukemia Anyone can get leukemia. ALL incidence was approximately twice that of AML. including the examination of the cells in blood or marrow.
the overall relative survival rate was nearly 50 percent. Thirty-two percent more males than females are living with leukemia. Epidemiology and End Results) Cancer Statistics Review 1975-2004.6 10-14 0.4 percent Five-Year Relative Survival Rates for All Ages. National Cancer Institute.3 1.8 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.1 Incidence (per 100. and in 1996-2003.1 4. 2007. The five-year relative survival rate has more than tripled in the past 47 years for patients with leukemia. For acute leukemia.2 15 13 11 9 7.Age-Specific Incidence Rates for Acute Myelogenous Leukemia (All Races). By 1975-1977.7 percent overall.2 10. In 1960-1963.8 percent • AML: 20. The relative survival rates differ by age of the patient at diagnosis. the five-year relative survival rates overall were: • ALL: 65. the five-year relative survival rate had jumped to 35 percent.2 23 21 19 19. All Types Leukemia. National Cancer Institute. 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. 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. During 1996-2003.4 percent for children under 5 • CLL: 74. Treatment of Leukemia The aim of treatment is to bring about a complete remission.3 percent overall.4 5-9 0.9 25-29 1.9 20-24 0. Relapse indicates return of the cancer cells and the return of other signs and symptoms of the disease.9 15-19 0.5 21. a patient had a 14 percent chance of living five years.6 2. LEUKEMIA page 8 LYMPHOMA MYELOMA . 90. gender.3 3. a complete remission (no evidence of disease in the blood or marrow) that lasts five years after treatment often indicates cure.1 for children under 15 • CML: 44. race and type of leukemia. Treatment centers report increasing numbers of patients with leukemia who are in complete remission at least five years after diagnosis of their disease. Complete remission means that there is no evidence of the disease and the patient returns to good health with normal blood and marrow cells.7 7 5 3 1 0 1. Epidemiology and End Results) Cancer Statistics Review 1975-2004.000) 17 15. 54.4 <1 0. 2007. when compared to a person without leukemia.2 1. 2000-2004 25 23.8 1-4 0.
500 deaths from CLL and 1.020 240 3. 1964:24:477-494. Despite this decline.320 males and 9. There will be an estimated 8. SEER (Surveillance. 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.970 250 2. deaths from leukemia are expected to be distributed in the following numbers: In 2007. In 2007.990 490 6. Blood. There will be an estimated 4. Estimated Deaths (All Age Groups) from All Types of Leukemia in 2007 Type Acute lymphocytic leukemia Chronic lymphocytic leukemia Acute myelogenous leukemia Chronic myelogenous leukemia Other. Survival Rates 50% 40% 30% 20% 10% 0% 19641 197519772 197819802 198119832 198419862 198719892 199019922 199319952 199620032 3% Years Figure 6: The graph shows childhood ALL five-year relative survival rates have improved significantly over the past nearly 40 years. about 515 children under the age of 14 are expected to die from leukemia.710 9. leukemia will be the fifth most common cause of cancer deaths in men and the sixth most common in women. Deaths It is anticipated that approximately 21.940 3.790 deaths in the United States will be attributed to leukemia in 2007: 12. 2. in Children Under 15 Years of Age. leukemia causes more deaths than any other cancer among children and young adults under age 20. Implications of long-term survivals in acute stem cell leukemia of childhood treated with composite cyclic therapy.990 deaths from AML and 490 deaths from CML.420 deaths from ALL. Cancer Statistics Review.500 8. Hispanics with leukemia who are under the age of 25 had the highest mortality rates from the disease between 1990 and 1999.Five-Year Relative Survival Rates for Acute Lymphocytic Leukemia.470 females. unclassified forms of leukemia Total Overall 1.790 Male 820 2. 2007.560 5. 1975-2004. Sources: 1. 2007.680 12. National Cancer Institute. LEUKEMIA LYMPHOMA MYELOMA page 9 .320 Female 600 1. Unclassified forms of leukemia will account for 6. In 2007. 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. 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. Epidemiology and End Results).390 additional deaths.420 4. Zuelzer WW. Non-Hispanic whites diagnosed with leukemia over the age of 44 had the highest death rates during this period. American Cancer Society.470 Table 4: Source: Cancer Facts & Figures 2007.390 21.
Non-Hodgkin lymphoma is the fifth most common cancer in males and females in the United States. the difference was small.5 percent of all lymphomas diagnosed in 2007. rose by 84 percent from 1975 to 2004. population who are living with lymphoma.953 people living with nonHodgkin lymphoma for a total of 544. The incidence of Hodgkin lymphoma is consistently lower than that of non-Hodgkin lymphoma.380 Table 5: Source: Cancer Facts & Figures 2007. Lymphoma results when a lymphocyte (a type of white blood cell) undergoes a malignant change and begins to multiply. 2007 Type Hodgkin lymphoma Non-Hodgkin lymphoma Total Male 4.8 percent. Living with Lymphoma In the United States in 2007. The reasons for the development of non-Hodgkin lymphoma are not certain. The bacterium Helicobacter pylori is associated with the development of lymphoma in the stomach wall.266 members of the U.313 people living with Hodgkin lymphoma (active disease or in remission) and 405.670 Female 3.190 63.190 cases of non-Hodgkin lymphoma). and each has prognostic factors that categorize it as more or less favorable. eventually crowding out healthy cells and creating tumors that enlarge the lymph nodes or other sites in the body. The age-adjusted incidence of non-Hodgkin lymphoma Incidence by Race and Ethnicity Although blacks in their mid 20s to late 40s have higher incidence rates of non-Hodgkin lymphoma than whites.9 per 100.Lymphoma Lymphoma is a general term for a group of cancers that originates in the lymphatic system. or low.000 at ages 20 to 24 for males and 1. Persons infected with the human immunodeficiency virus (HIV) have a much higher risk of developing lymphoma. malignant cell found in Hodgkin lymphoma tissues). Age-specific incidence rates of non-Hodgkin lymphoma are 2. while 0.990 32.200 38. Each histologic grouping is diagnosed and treated differently. After 50 to 54 years of age. American Cancer Society. Both Hodgkin and non-Hodgkin lymphomas are more common in males than in females. In 2004.3 per 100. including the presence of an abnormal cell called the ReedSternberg cell (a large. in general whites have higher incidence rates than blacks.S. These risk factors explain only a small proportion of cases. incidence rates for non. 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. Fifty-three percent of the blood cancers diagnosed are lymphomas. Incidence rates for Hodgkin lymphoma tend to be higher among males than among females. New Cases About 71.000 for females. intermediate and high grade. there are 138.9 per 100.720 28. The Epstein-Barr virus causes Burkitt’s lymphoma in Africa.710 Total 8.000 for females. Hodgkin Lymphoma Hodgkin lymphoma is a specialized form of lymphoma and will represent about 11. they are 52. It is the sixth most common cause of cancer deaths in males and in females.7 percent of all cases of non-Hodgkin lymphoma will be diagnosed in children under 15 years of age this year.380 Americans will be diagnosed with lymphoma in 2007 (8. New Cases of Lymphoma by Gender. LEUKEMIA page 10 LYMPHOMA MYELOMA .190 71.6 per 100.190 cases of Hodgkin lymphoma and 63. Incidence by Gender Table 5 illustrates the breakdown of incidence of lymphoma by gender. By ages 60 to 64. The groups are often classified as indolent or aggressive. Immune suppression plays a role in some patients. 2007. Non-Hodgkin Lymphoma Non-Hodgkin lymphoma represents a diverse group of cancers with the distinctions between types based on the characteristics of the cancerous cells.000 for males and 38.470 34. More than four percent of all cases of Hodgkin lymphoma diagnosed in 2007 will be in children under 15 years of age. an average annual percentage increase of 2.
recurrent high fever. Radiation. chemotherapy or both may result in cures for most patients with Hodgkin lymphoma.Among women. loss of appetite and bone pain. 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. Deaths An estimated 19. This represents a significant improvement in the rate of recovery. Early stage. 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. In the United States. Adolescents are more commonly diagnosed with Hodgkin lymphoma than young children. Non-Hodgkin lymphoma is the fifth most common cancer in Hispanics. and is the eighth most common cause of cancer death in that group.9 percent). 3. The incidence in this group decreased almost steadily and significantly between 1975 and 1999. cell type and location of the lymphoma. the highest incidence of non-Hodgkin lymphoma is in Asian/Pacific islanders. In children from 0 to 19 years of age.1 cases per 100.0/1 million population).660 from non-Hodgkin lymphoma. and more than 46-fold to 112.5 percent. persistent fatigue. indigestion and abdominal pain. troublesome itching and weight loss. about 10. and non-Hodgkin lymphoma.to 24year-old individuals. 4.1 per 100.730 persons will die from lymphoma in the United States in 2007 (18. The five-year relative survival rate for non-Hodgkin lymphoma patients has risen from 31 percent in whites in 1960-1963 to 63. sweating at night. armpit or groin. Lymphomas (Hodgkin lymphoma. most children with nonHodgkin lymphoma did not live five years after diagnosis. It has remained fairly constant since 1999. Survival for Adults Hodgkin lymphoma is now considered to be one of the most curable forms of cancer. Hodgkin lymphoma incidence rates are higher in adolescents and young adults than in adults in their middle years.5 percent) are the third most common cancers in children. localized non-Hodgkin lymphoma is sometimes treated with radiation. followed closely by Hispanic children of all races (24. lymphomas are most commonly diagnosed in whites (24. night sweats.070 from Hodgkin lymphoma). Hispanics of all races have the second highest incidence rates of non-Hodgkin lymphoma after whites.5/1 million population). Five-year relative survival is now 95 percent for Hodgkin lymphoma in children aged 0 to 14 years. following leukemia (26. Non-Hodgkin lymphoma is the ninth most common cause of cancer death in males and the seventh in females in the United States.5 percent. The most common early sign of other forms of lymphoma is also painless swelling of the lymph nodes – usually in the neck. the highest incidence of non-Hodgkin lymphoma is in non-Hispanic whites. Treatment for non-Hodgkin lymphoma sometimes includes vaccines and other forms of immunotherapy. widespread disease requires chemotherapy or chemotherapy and/or monoclonal antibody therapy with radiation.000 children in 2004.400 children under the age of 15 will be diagnosed with cancer in 2007. comprising nearly 5 percent of all cancers diagnosed. Signs and Symptoms Signs and symptoms of Hodgkin lymphoma include painless swelling of lymph nodes in the neck. In children up to age 14 years. The rate increases more than 18 times to 45. Death rates have been declining for Hodgkin lymphoma patients since the mid-1970s.000 persons at ages 80 to 84. 1.2 percent for Hodgkin lymphoma in people under 20 years of age. Even in the mid-1970s.000 people occur in 20. groin or in the abdomen. excessive tiredness. Symptoms also often include fever.4 cases per 100. Treatment Hodgkin lymphoma is often treated with radiation and chemotherapy. About 2. In children under 20 years of age.8 percent) and neoplasms of the brain and other nervous tissue (17. LEUKEMIA LYMPHOMA MYELOMA page 11 .8 percent for all races in 1996-2003. depending on the tumor size. armpit. From ages 15 to 19. five-year relative survival for non-Hodgkin lymphoma is now 83. Incidence in Adults The incidence of non-Hodgkin lymphoma increases with age.000 by ages 60 to 64. It is rarest among American Indian/ Alaskan native children.1 cases per 100.
Table 6: Source: SEER (Surveillance.6 32.9 7.1 63. Epidemiology and End Results) Cancer Statistics Review 1975-2004. LEUKEMIA page 12 LYMPHOMA MYELOMA .730 Male 770 9. Epidemiology and End Results) Cancer Statistics Review 1975-2004.0 3.8 112.5 <1* 1-4 5-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 Age in Years 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85+ Figure 8: Sources: SEER (Surveillance. Epidemiology and End Results) Cancer Statistics Review 1975-2004.4 2. 2007.0 0.Age-Specific Incidence Rates for Hodgkin Lymphoma. National Cancer Institute.000) 5 4 3 2 1 0 0.8 3. National Cancer Institute.3 4.0 45.060 9.8 2. 2000-2004 6 Incidence (per 100. *<16 cases per time interval.1 0.4 80.4 2. 2007.0 1. * <16 cases for time interval.0 2.1 3. 2007.1 4.8 4.5 10.1 3.000) 70 60 50 40 30 22.600 10.2 1.1 0. American Cancer Society. National Cancer Institute.4 15.360 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 110 100 90 80 Incidence (per 100.070 18.3 <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.6 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 1.4 3. 2007.2 4.370 Female 300 9.4 2.4 4.4 2.660 19.0 100. Age-Specific Incidence Rates for Non-Hodgkin Lymphoma.9 4.0 20 10 0 0.1 102.9 3.9 1.
• The incidence rate in men (7/100. the cell that forms plasma cells.000) 40 30 20 10 0 0-24 0. Myeloma was the 10th most common cause of cancer deaths for women in 2000-2004. Bortezomib has been approved for treating myeloma in patients who have had at least two prior therapies. 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85+ Age in Years Possible Causes The cause of myeloma is not known. The U. destroying normal bone tissue. Deaths Approximately 10.4 33. It grows continuously and forms masses of plasma cells. The highest rates are found in black men 80 to 84 years of age and older (105/100. Survival Current statistical databases show that overall five-year relative survival in patients with myeloma has shown a significant improvement since the 1960s: 12 percent in 1960-1963 for whites to 34 percent from 1996-2003 for all races. but primarily in the bone marrow.1 21. especially.1/100. Thalidomide is approved by the FDA for use in treating newly diagnosed myeloma. median age at death from multiple myeloma is 74. • The median age at diagnosis for African-Americans is 67. two or three drugs are used simultaneously.5/100.5/100. 2007. has been increasing.000) for all racial and ethnic groups.0 37. the patient’s own stem cells are used (autologous stem cell infusion). a B lymphocyte. From 2000 to 2004. Malignant plasma cells produce an abnormal protein called monoclonal immunoglobulin. causing pain and crowding out normal blood cell production. Figure 9: Source: SEER (Surveillance. 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. Lenalidomide is approved by the FDA in combination with dexamethasone for the treatment of myeloma patients who have received at least one prior therapy. (11. 20-24). Patients may have anemia.424 people in the United States are living with myeloma. a type of white blood cell found in many tissues of the body. Total survival for white males.000).8 14. 5-9.000).2/100. approximately double. In myeloma.940 women) new cases of myeloma will be diagnosed in the United States in 2007. 1-4.1 0. At times. LEUKEMIA LYMPHOMA MYELOMA page 13 . National Cancer Institute.000). myeloma was the 10th most commonly diagnosed cancer among African-American men and women. becomes malignant. It is 71 for African-Americans.000) is 56 percent higher than for women (4. New Cases An estimated 19.5 3.Myeloma Myeloma is a cancer of the plasma cells. 10-14.1 Signs and Symptoms Often the first symptom of myeloma is bone pain caused by the effects of myeloma cells in the marrow. Treatment may include intensive chemotherapy followed by stem cell transplantation to restore normal blood cell production.3 0.000 to 3.7 1. 15-19.960 men and 8.4 35. and it rarely occurs in people under age 45. • The median age at diagnosis is 70. Treatment Chemotherapy for myeloma has led to sustained remissions in some patients.9 9. Usually. Living with Myeloma An estimated 60. Approximately 3 percent of all cancer-related deaths among AfricanAmericans in 2000-2004 were from myeloma. especially in the marrow. but it is the most difficult blood cancer to treat successfully. Age-Specific Incidence Rates for Myeloma.1 5. SEER 17 areas (<1.000) of myeloma than those of European descent (5. • Americans of African descent have a much higher incidence rate. Recurrent infections may be an early sign of the disease.3/100. Sixty percent of those were diagnosed with the disease within the past four years.900 (10.790 deaths from myeloma are anticipated this year. The onset of myeloma interferes with normal production of antibodies and makes myeloma patients susceptible to infections. 2000-2004 Incidence (per 100. Epidemiology and End Results) Cancer Statistics Review 1975-2004. tire more easily and feel weak.S.1 28. *<16 cases for each age interval. The mortality rate from myeloma for people of African descent is more than double the rate for whites (7. Treatment is aimed at slowing progress of the disease. Fractures may occur as a result of the weakened bones.
1 Table 10: Source: SEER (Surveillance.8 14.2 2.0 7. 2007.6 Female 9.1 11.000 population and are age-adjusted to the 2000 population. (Based on SEER 17 areas.9 2. per 100.3 19. 2007.6 4. Epidemiology and End Results) Cancer Statistics Review 1975-2004.0 Female 8.2 6.1 9.0 Female 9. Rates are per 100. 2007. per 100. National Cancer Institute.6 Male 16.000 Population (2000-2004) Type Leukemia Non-Hodgkin lymphoma Hodgkin lymphoma Myeloma Overall 12.9 5.5 Table 8: Source: SEER (Surveillance. Lymphoma and Myeloma The following tables showing incidence rates for leukemia.Incidence Rates: Leukemia. Epidemiology and End Results) Cancer Statistics Review 1975-2004.1 2. for Blacks. Hodgkin and non-Hodgkin lymphoma and myeloma use figures from 2000-2004. (Based on SEER 17 areas. the most recent available.5 16.7 24.) Table 9: Source: SEER (Surveillance. per 100.0 23.6 2. (Based on SEER 17 areas.3 Male 13. National Cancer Institute.2 18.7 5.) Incidence Rates by Gender.000 Population (2000-2004) Type Leukemia Non-Hodgkin lymphoma Hodgkin lymphoma Myeloma Overall 10.3 2.2 3.) LEUKEMIA page 14 LYMPHOMA MYELOMA .4 11.2 14.4 4. Epidemiology and End Results) Cancer Statistics Review 1975-2004.3 2.9 17.1 3. All Races.5 Incidence Rates by Gender. Incidence Rates by Gender. National Cancer Institute.2 Male 16.000 Population (2000-2004) Type Leukemia Non-Hodgkin lymphoma Hodgkin lymphoma Myeloma Overall 12. for Whites.0 2.8 20.
560 770 890 3.550 * * * * *20 * * * * 60 * * * 50 * * * * * * * * * * * * * * * * * * 70 * * 50 * * 60 * * * * 80 * * * * * * * 390 Table 11: Sources: Cancer Facts & Figures 2007. American Cancer Society. Centers for Disease Control and Prevention.370 250 280 2.140 60 260 80 410 1.390 1. total because of rounding and exclusion of estimates that are fewer than 50 cases. and additional data supplied by the American Cancer Society based on data from the U.040 70 44. **State estimates may not add up to U.140 380 140 1.540 1.300 110 63.310 800 600 900 920 330 1.510 500 60 70 900 380 220 160 280 430 100 370 460 730 310 170 400 70 110 120 80 650 120 1. CA A Cancer Journal for Clinicians.070 110 1. 1969-2004. 2006. American Cancer Society.030 570 * 610 210 360 1. numbers are small and NCI and ACS are having difficulty fitting them into the Pickle et al. The method of derivation. Note: These estimates are offered as a rough guide and should be interpreted with caution.410 560 * 740 230 230 930 70 300 50 350 1. Mortality Public Use Data Tapes. *Estimate is fewer than 50 cases.240 170 550 130 800 3.610 150 2. ***Hodgkin lymphoma estimates are not available for 2007. is described by Pickle et al. *Estimate is fewer than 50 cases. National Center for Health Statistics.500 430 1.150 290 270 70 * 1.610 670 610 110 60 3.080 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. which is new for 2007.530 1. by State. Used with permission. Note: These estimates are offered as a rough guide and should be interpreted with caution. 2007 State Leukemia Non-Hodgkin Lymphoma Myeloma Hodgkin Lymphoma Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Dist.130 300 80 900 960 300 1.880 240 250 50 50 1.240 740 80 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 4.160 1.250 1.190 290 * 280 200 1. Numbers are rounded to the nearest 10.630 540 80 120 990 510 310 230 320 330 100 390 490 770 400 210 460 80 150 160 100 680 120 1.370 100 * 430 380 130 350 * 19.410 130 50 500 490 130 490 * 21.260 220 400 420 290 2.S.. Table 12: Sources: Cancer Facts & Figures 2007.360 960 170 220 2.S. and additional data supplied by the American Cancer Society.010 1.170 480 1.790 330 * 320 200 1.300 470 90 100 750 430 300 220 290 310 110 320 420 660 350 170 500 80 110 130 90 600 120 1.080 600 7.710 570 500 2.Estimated New Cases of Blood Cancers by Site. of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Total** 350 * 400 240 2.360 610 * 950 290 260 1. They cannot be compared with previous years’ estimates to determine cancer incidence trends.330 260 780 180 1. LEUKEMIA LYMPHOMA MYELOMA page 15 .030 910 620 420 680 680 250 630 1.680 920 340 890 170 290 330 190 1. 2007 State Leukemia Non-Hodgkin Lymphoma Myeloma Hodgkin Lymphoma*** Estimated Deaths from Blood Cancers by Site.200 350 4.670 1.S.160 140 50 360 440 170 320 * 18.660 210 * 190 120 1.830 240 230 60 * 1.520 310 3. 2007. total because of rounding and exclusion of estimates that are fewer than 50 cases. Used with permission. by State.190 880 870 170 100 4.180 4. January/February 2007.070 Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Dist. model (see below).070 80 330 70 480 1. Numbers are rounded to the nearest 10. **State estimates may not add up to U. 2007.550 2.
S. mostly upward. but these figures do not take into account differences in geography.” as per SEER table I-21. 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. Definitions Incidence is the number of newly diagnosed cases for a specific cancer or for all cancers combined during a specific time period. race or sex. estimates of cancer incidence. This change means that the 2007 incidence estimates are not comparable with previous estimates for determining cancer incidence trends. The data can be extrapolated for the entire United States by multiplying by the population ratio. no matter how long ago that diagnosis was.S. Prevalence may be calculated in a number of different ways. The data presented in this report are an extrapolation or estimate of the number of cases reported by the 17 Surveillance. It considers deaths from all causes. state-by-state data for incidence of Hodgkin lymphoma are not available because these numbers are so small. Incidence rates can be calculated based on a number of factors such as age. Because of this change in method. January/February 2007.Notes and Definitions Notes The United States does not have a nationwide reporting system or registry for blood cancers. cancer or otherwise. race and ethnicity in various regions and region-specific health risks. especially in looking at populations in which individuals have had more than one type of cancer. 2007. This rate is calculated by adjusting the observed survival rate so that the effects of causes of death other than those related to the cancer in question are removed. CA A Cancer Journal for Clinicians. Because of changes in the information — such as racial classification — gathered in the 2000 U. Bureau of the Census’ 2000 population data for that region. The specified date is 1/1/2004 for the prevalence estimates. in some cases fewer than 17 SEER regions) and death data from the National Center for Health Statistics. 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. This year. so the exact number of cases is not known. based on the “first invasive tumor for each cancer site diagnosed during the previous 29 years (1975-2003). the data presented in the 2007 SEER report placed online on April 15. prevalence numbers reported may vary depending upon the method used to determine them. The relative survival rate is a comparison of survival to a person who is free of the disease. Thus. Relative survival rate is an estimate of the percentage of patients who would be expected to survive the effects of the cancer.) Prevalence is the estimated number of people alive on a certain date in a population who previously had a diagnosis of the disease. 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. his or her survival with leukemia may not be counted in leukemia prevalence statistics. Because of reporting delays from some of the SEER regions. population) that belong to the National Program of Cancer Registries. When expressed as a rate. Census. Thus.S. if a person is initially diagnosed with melanoma and later develops leukemia. The SEER (17 region) data cover only about 26 percent of the U. In this report. In some prevalence statistics. It includes new (incidence) and preexisting cases and is a function of both past incidence and survival. the American Cancer Society changed its method of estimating cancer incidence. Epidemiology and End Results Program (SEER) regions (or. 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. only the first diagnosed cancer counts.. 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.S. LEUKEMIA page 16 LYMPHOMA MYELOMA . in comparison to the 2002 SEER report. 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. may be incomplete in some cases and the data may reflect adjustments that anticipate changes that will occur once the actual data are received. population. it is the number of new cases per standard unit of population during the time period.
Zou Z. Jemal A. Barr R. No. Epidemiology. Miller BA. Howe HL. Epidemiology. 06-5767. Hachey M. 174. MD. MD.” Bleyer A. 2007. Feuer EJ. Cancer Facts & Figures for African Americans 2007-2008. National Cancer Institute. CA A Cancer Journal for Clinicians Vol. January. Reichman M. Krapcho M. The Oncologist Vol.gov/csr/1975_2004/ LEUKEMIA LYMPHOMA MYELOMA page 17 . NIH Pub. 12. Sheaffer J. and Multiple Primary Cancer Analyses from the Surveillance. Cheson B. “A New Method of Estimating United States and State-Level Cancer Incidence Counts for the Current Calendar Year. 2007. Ries LAG (eds). Including SEER Incidence and Survival: 1975-2000.” O’Leary M.TheOncologist.com/cgi/content/full/12/1/20. O’Leary M. Bethesda. Keller F. 30-42. O’Leary M. O’Leary M.amcancersoc. Bethesda. Including SEER Incidence and Survival: 1975-2000. In Cancer Epidemiology in Older Adolescents and Young Adults 15 to 29 Years of Age. Trends. Hao Y. 2006. Barr R. Reichman ME. January/February. 2007. National Cancer Institute. http://www. No.Citations Source Citations Cancer Facts & Figures 2007. 065767. National Cancer Institute. Eisner MP. National Cancer Institute. Bethesda. Bleyer A. Including SEER Incidence and Survival: 1975-2000. 2006. 20-37. Ries LAG. Stock W. Atlanta: American Cancer Society. SEER (Surveillance.org/cgi/content/full/57/1/30. Barr R. Horner MJ. Howlander N. Clegg L. 1975-2004. pp. Ward E. p. Bethesda. 065767. “Highlights and Challenges. Barr R. based on November 2006 SEER data submission.cancer. Ries LAG (eds). NIH Pub. Mariotto A. “Lymphomas and Reticuloendothelial Neoplasms. “Cancer Statistics. 2007. MD. Nachman J. http://seer. Ries LAG (eds). Tiwari RC. Atlanta: American Cancer Society.” Mattano L Jr. Shu X-O. Ross J. 39-51. pp. 25-38. pp. Feuer EJ. pp.” Hayat MJ. 57. No. “Leukemias. MD. http://caonline. and End Results) Cancer Statistics Review.” Pickle LW. In Cancer Epidemiology in Older Adolescents and Young Adults 15 to 29 Years of Age. posted to the SEER Web site 2007. Howlader N. Edwards BK (eds). Bleyer A. and End Results (SEER) Program. Edwards BK. Melbert D. 2006. NIH Pub. In Cancer Epidemiology in Older Adolescents and Young Adults 15 to 29 Years of Age. Bleyer A.
We offer a wide variety of programs and services in support of our mission: Cure leukemia. They are: 1) Career Development Program (CDP)-basic research. The Specialized Center of Research (SCOR) in Leukemia. • Special Fellows are awarded $60. the Society has awarded more than $550 million in research grants.6 million annually on research. Hodgkin’s disease and myeloma. are granted each year. lymphoma or myeloma. lymphoma and myeloma. lymphoma and myeloma research comprise four review subcomittees. Lymphoma and Myeloma These center grants are awarded to a cluster of at least three research groups that interact to foster advances in the diagnosis.000 over three years. The Grant Review Process Scientists and physician-scientists who are experts in the field of leukemia. diagnosis or prevention in the near term. the Society’s grant programs are among the most prestigious in the fields of blood cancers. Awards up to $200.000 over three years.000 a year for a total of $550. treatment or prevention of leukemia. 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. Translational Research and the Specialized Center of Research (SCOR).000 over three years.000 over five years. Thus. Research grants are awarded in three program areas: Career Development.000 a year for a total of $180.000 a year for a total of $550.000 over five years. research reaching a clinical trial can receive $1 million over five years to facilitate new drug discovery or advances in diagnosis or prevention. each focused on the discovery of new approaches to benefit patients or those at risk for developing leukemia. 3) Translational Research Program.25 million. 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 is a nonprofit organization that relies on the generosity of individual and corporate contributions to advance its mission. Career Development Program The Career Development Program supports promising young scientists (Scholars.000 per year for three years. lymphoma. Awards go to those groups that best demonstrate the synergy that will occur from their close interaction. • Fellows are awarded $50. Translational Research Awards are made for an initial three-year period. Funding for two additional years may be provided for highly promising projects that are entering phase I clinical trial. leukemia. to a total cost of $6. for a total of $600. lymphoma and myeloma should be encouraged worldwide. • Special Fellows in Clinical Research are awarded $60.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. Research Research Grant Programs The Society’s research programs are based on the belief that all scientifically sound approaches toward a cure for. Translational Research • Scholars in Clinical Research are awarded $110. Translational Research Program The Translational Research Program provides early-stage support for research on leukemia. The participating scientists may be at different institutions or from any country. 2) CDP-clinical research. or control of. and improve the quality of life of patients and their families.000 a year for a total of $150. The SCOR grants also support scientific core laboratories to provide access to innovative technology if required by the participating research programs.000. Now supporting $61.000 a year for a total of $180. Each SCOR is funded up to $1. The SCOR program brings together research teams working in complementary areas. lymphoma and myeloma that is intended to advance treatment.25 million per year over a five-year period. Since the first funding in 1954. The program is expected to generate new knowledge and breakthrough discoveries.
org. call (877) LLS-COPAY ( 557-2672) or email copay@LLS. Information specialists are oncology social workers and health educators who provide callers with current information on blood cancers. lymphoma. Professional Education The Society serves the continuing educational needs of the medical and research community through professional symposia offered throughout the year. treatment and prevention of leukemia. lymphoma and myeloma. on the Society’s Web site. It is continually being updated and expanded to support and promote the Society’s mission. treatments. These offices conduct lifeenhancing patient services. and encourages greater communication among patients. LEUKEMIA LYMPHOMA MYELOMA page 19 . Other meetings are held for the Society’s grantees. ET. Each year. ET. the Translational Research Grant Progress Review Meeting and the SCOR Progress Review Meeting.” Chapter Programs: Family Support Groups: The Society has developed more than 360 Family Support Groups at 68 chapters. serves a wide variety of education and information needs. Co-Pay Assistance Program Patients with AML.LLS. Patients. Teleconferences and Webcasts The Society sponsors more than 25 educational teleconferences and Webcasts each year on topics of interest to patients and caregivers. myelodysplastic syndromes (MDS) and other blood cancers.LLS. Information on registration for these free events can be accessed at www.org or by or emailing researchprograms@LLS. Information Resource Center (IRC) The Society strives to be the world’s foremost source of information on leukemia. The site features a comprehensive overview of blood cancers.org. The Society also hosts numerous teleconferences and Webcasts.org. is held each December on the Friday immediately before the American Society of Hematology meeting. This support should advance the understanding. Patients needing assistance may apply on the Society’s Web site. As of June 30. including support groups.LLS.m.LLS. and applications for the Society’s three research programs may be obtained by visiting www.LLS. Patient Services The Society has a network of 68 chapters throughout the United States and Canada.org. information about our peer-to-peer program First Connection and other programs. sponsored by the Society. the Society’s programs and services. peer counseling and patient financial aid. audio. They are available to talk one-onone. instructions. myeloma. The Society’s Web Site The Society’s Web site. to 5:00 p. Guided by two volunteer oncology health professionals. Educational Materials An extensive collection of free educational materials are offered to patients and health professionals. These include the Stohlman Scholar Symposium.LLS. The educational program offers varying formats to facilitate the exchange of information and ideas on the newest developments in cancer research and treatment. First Connection: This program links newly diagnosed patients to a peer volunteer who has experienced a similar diagnosis.m. 9 a. the Society distributes more than 1 million booklets. clinical trials and offer guidance on coping. and click “Live Help. lymphoma.m. The Society funds several Focused Workshops each year on important topics relevant to hematological malignancies. The user has the opportunity to create personalized pages with identified interests.org. friends and healthcare professionals.org or faxing to (914) 949-6691 or contacting the Research Department at (914) 949-5213. www. www. where medical professionals share the latest research findings. to 6 p.org.org.important projects to advance the Society’s mission. Much of the content of these materials is available to view and download at www. their families and healthcare professionals. families and professionals may call the IRC toll free at (800) 955-4572 in addition to corresponding by email at infocenter@LLS. Family Support Group locations. You may also chat online with an information specialist. each group provides information and support.m. 2007 the Society will have 379 active grantees at 116 institutions in the United States and abroad.org/copay. from 10:00 a.LLS. www. Monday through Friday. 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. brochures and videos through the IRC and local Society chapters. podcasts and Webcast archives of these programs are available at www. The IRC is a worldwide link to information and resources useful to patients. Guidelines. A trained patient volunteer currently in remission phones the new patient to share information and support. families. The Annual Research Symposium.
families and healthcare professionals with a clear description of what clinical trials are. This program is also accessible as a Webcast at www. On the state level. This nursing education program provides an overview of CML. The patient education program was funded at $18 million through 2007.000 and has become a potent voice in public policy deliberations. New insights. DC. New Directions in Myeloma Therapy: This program presents an overview of myeloma. In 2002. The Society has identified key issues that currently shape its advocacy agenda. Printed literature. Welcome Back: Facilitating the Return to School for Children with Cancer: A new addition to The Trish Greene Back to School Program. This Society program is being supported by Celgene Corporation and Millennium Pharmaceuticals. representing to policy makers at all levels of government the healthcare quality concerns and medical research interests of patients and their families.and long-term effects that children may experience after treatment. It is supported by Amgen Oncology. unrestricted educational grant from Genentech BioOncology and Biogen Idec Inc. 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. treatments and future directions for NHL are also discussed. videos and other materials to aid the process are available through all local chapters. 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. patients and school personnel to assure youngsters a smooth transition from active treatment back to school. treatments. staging and classification of nonHodgkin lymphoma (NHL).S. CML Issues and Insights: A Nursing Education Program on Chronic Myelogenous Leukemia. Society volunteers and staff visit Capitol Hill regularly to lobby Congress in support of issues that impact research and patient care. 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. treatments. and offers numerous resources that can assist childhood cancer survivors to flourish in the school environment posttreatment. reimbursement of up to $500 per year helps cover the costs of transportation. that program has funded some $30 million in additional blood cancer research.LLS. That network now numbers more than 35. diagnosis. Patient financial aid funds are subject to availability. This program is made possible by the Lance Armstrong Foundation.org and is being sponsored by a generous. This program is provided through an unrestricted educational grant from Millennium Pharmaceuticals. how cancer drugs are developed and what the emerging treatment options are for leukemia. the Society has successfully ensured coverage of routine care in cancer clinical trials in three states and secured additional funding for patient support programs in four others. providing additional support for blood cancer patients and their families nationwide. Advocacy Since 1994. Department of Defense’s medical research program. 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. The Trish Greene Back to School Program for Children with Cancer: This program is designed to increase communication among healthcare professionals. The Path to Progress: Clinical Trials in Blood Cancers: This program provides patients. drugs and various treatments not covered by insurance. emerging therapies and managing side effects and how to find emotional support when living with the illness. the Society successfully lobbied Congress to institute a blood cancer research initiative as part of the U.Patient Financial Aid Program: For more than 31 years. this education program discusses possible emotional and cognitive short. lymphoma and myeloma. LEUKEMIA page 20 LYMPHOMA MYELOMA . Working through chapters across the country. This program is being sponsored by an unrestricted education grant from Novartis Oncology. Meet the Expert on Non-Hodgkin Lymphoma: This program presents basic information on terminology. the Society’s advocacy program has been a strong voice in Washington. emerging therapies and side effects and addresses the unique challenges of nursing management of these patients. risk factors. To date. parents. Through the Patient Financial Aid Program. In 2001. the Society has helped patients demonstrating a need for financial assistance cover a portion of their treatment costs.
The Leukemia & Lymphoma Society extends special thanks to Myrna Watanabe.D. Milton Eisner of SEER. 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.seer. of the American Cancer Society (ACS). NCI. provided statistical assistance. for compilation of data for this publication. and Rebecca Siegel.gov. Ph. It is distributed as a public service by The Leukemia & Lymphoma Society Inc..cancer. This publication is designed to provide information in regard to the subject matter covered.
Suite 310 White Plains. PS80 35M 6/07 .955. The Society is a nonprofit organization that relies on the generosity of individual.LLS.LLS Information Resource Center (IRC): 800. corporate and foundation contributions to advance its mission. lymphoma.HELP. New York 10605 Tel: 888.4572 www.Home Office 1311 Mamaroneck Avenue.org Our mission: Cure leukemia. and improve the quality of life of patients and their families. Hodgkin’s disease and myeloma.
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