Facts 2007-2008

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

L eukemia
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

10 Lymphoma

Tables
6
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

13 Myeloma

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

LEUKEMIA

LYMPHOMA

MYELOMA

Cover Photo: Light microscopy (Magnification = 700x) of a human lymphoma cell. Credit: Dr. Cecil H. Fox/Photo Researchers, Inc.

and myeloma.310 people in the United States this year. 44. lymphoma and myeloma in 2007. • Thirty-two percent more males are living with leukemia than females. the National Cancer Institute’s Surveillance.seer. • Leukemia causes more deaths than any other cancer among children and young adults under the age of 20.730 people will die from lymphoma (1. lymphoma and myeloma. This abnormal accumulation interferes with the production of healthy blood cells. and its age-adjusted incidence rose by nearly 84 percent from 1975 to 2004. 1998. 63. *Myeloma Biology and Management. National Cancer Institute.520 people in the United States will be diagnosed with leukemia. Hodgkin and non-Hodgkin lymphoma. 18. • In 2007. • In general. 405.4 percent of the 1. Survival • An estimated 823.660 from non-Hodgkin).650 total cancer-related deaths. • Every five minutes.190 cases of non-Hodgkin). 2nd Edition.Executive Summary Facts 2007-2008. LEUKEMIA LYMPHOMA MYELOMA page 1 . nonacute myelogenous and monocytic leukemias Lymphoma: • There are 544. Myeloma: • • • • There are 60. 2007 and SEER 19731993. someone dies from a blood cancer. Leukemia.349 Americans are living with leukemia. This statistic represents 143 people each day.gov. someone is diagnosed with a blood cancer.190 cases of Hodgkin. From 1975 to 2004. Hodgkin and non-Hodgkin lymphoma and myeloma will account for nearly 9.659 people in the United States who are either living with or are in remission from leukemia. 10. • New cases of leukemia. is a compilation of the most recent data on leukemia. 19. National Cancer Institute.953 either have or are in remission from non-Hodgkin lymphoma (NHL). the likelihood of dying from most leukemias*. • Every 10 minutes. More males are diagnosed with leukemia and more males die of it than females.790 people will die of leukemia.790 people will die from myeloma. Cancer Statistics Review 1975-2004 (see Notes. www. These data were published online by SEER.313 either have or are in remission from Hodgkin lymphoma. • This year. 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. 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. • This year. This year.444. • These blood cancers will account for 9. Mortality from the disease increased 24 percent. 1975-2004. in April 2007.900 people will be diagnosed with myeloma. *except acute myelogenous leukemia (AML) and other. Deaths • Leukemia. or nearly six people every hour. Highlights from the Report Include: New Cases • An estimated 135.cancer. Epidemiology and End Results Program.3 percent of the deaths from cancer in 2007 based on the 559. which becomes malignant and multiplies continuously. page 16). This year. lymphoma and myeloma will cause the deaths of an estimated 52.266 people living today with lymphoma. an annual publication. lymphoma and myeloma decreased from 1995 to 2004 (the last year data were available).1975-1977 vs. • Non-Hodgkin lymphoma is the fifth most common cancer in the United States. • In 2007.424 people living today with myeloma. 1960-1963 1975-1977 1996-2003 Figure 1: Sources: SEER (Surveillance. The next SEER Cancer Statistics Review is expected to be published online in April 2008. 71.380 new cases of lymphoma will be diagnosed in the United States (8.070 from Hodgkin. Epidemiology and End Results) Cancer Statistics Review. 19. 138. • Eighty-six percent of myeloma cases occur in people aged 55 and over. Five-Year Relative Survival Rates 1960-1963 vs.920 new cancer cases diagnosed in the United States this year. the incidence of myeloma increased 8 percent. Oxford University Press. The data within Facts 2007-2008 reflect the most recent statistics available from SEER.240 people will be diagnosed with leukemia. 21. 1996.

freezing and storing of cord blood have provided another source of stem cells for transplantation. especially in young children. a search of the National Marrow Donor Program registry of tissue-typed volunteers could be made for a matched unrelated donor. These diseases usually result from an acquired genetic injury to the DNA of a single cell. lymphoma and myeloma. 2007. 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. Estimated New Cases (%) of Blood Cancers in 2007 Myeloma 15% Leukemia 33% Lymphoma 53% Treatment Chemotherapy and Radiotherapy: The use of chemotherapy (anticancer drugs). for which a parent rather than a sibling could be the donor. There are two major types of stem cell transplants: syngeneic and allogeneic. The technique of harvesting stem cells from blood and cord blood has made transplantation available for more LEUKEMIA page 2 LYMPHOMA MYELOMA . The harvesting.About the Diseases Leukemia. However. 2007. An allogeneic transplant uses blood or marrow stem cells from a normal donor. decreased ability to fight infections and a predisposition to bleeding. 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. some types of Hodgkin lymphoma. Research is being conducted to improve socalled “haploidentical” transplant. They are considered to be related cancers because they arise from cells with a common origin (the lymphohematopoietic stem cells) and with related functions. 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. 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. If a sibling is not available. Such an approach would greatly lessen the proportion of children without a donor. slightly mismatched cord stem cell donors may be used quite successfully. studies suggest that two matched cord donors may result in a higher success rate in larger adults. Patients with acute lymphocytic leukemia (ALL). usually a brother or sister with the same tissue type. Hodgkin and non-Hodgkin lymphoma and myeloma are cancers that originate in a cell in the bone marrow or lymphatic tissues. The accumulation of malignant cells interferes with the body’s production of normal blood or immune cells and can result in severe anemia. In special instances. Syngeneic transplant describes the use of an identical twin as donor.) of larger adult patients. usually in combinations of two or more drugs. myeloma and lymphoma are usually treated with chemotherapy. 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. American Cancer Society. 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 for children. is largely responsible for the dramatic improvement in managing leukemia and lymphoma. Autologous transplantation uses the patient’s own marrow stem cells and is technically not transplantation since another person is not the donor. which becomes abnormal (malignant) and multiplies continuously. The technique is important. Patients with leukemia. (Numbers do not add up to 100% because of rounding.

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. Follow-Up Guidelines: The Children’s Oncology Group has established Long-Term Follow-Up Guidelines for Survivors of Childhood. 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. identify recurrence of the disease and detect long-term or late effects. Cancer survivors should have physical examinations yearly or more often. Imatinib mesylate (Gleevec®) is now the drug of choice in newly diagnosed patients with chronic myelogenous leukemia (CML). frozen and stored and later transplanted in the patient. Some treatment centers have follow-up clinics that provide a comprehensive. Cancers (http://www. Over time. thereby allowing doctors to plan treatment accordingly. is a source of stem cells for transplantation. as needed. marrow and immune system. two second-generation agents. and Young Adult LEUKEMIA LYMPHOMA MYELOMA page 3 . Gleevec offers several dramatic advantages to patients: oral administration.childrensoncologygroup. ablation of the recipient’s blood-cell forming and immune cells was the price that had to be paid to eradicate the leukemia. multi-disciplinary approach to monitoring and supporting cancer survivors. Regular examinations may include screening for cancer recurrence or the development of secondary cancer or other late effects of treatment.org/). Identifying these biomarkers will allow researchers to develop tests that can predict what effects an individual is at risk of developing. New Approaches to Treatment Several areas of research have resulted in new approaches to the treatment of leukemia. This still experimental approach greatly lessens the early toxicity of transplantation and has extended the age at which recipients with leukemia. lymphoma or myeloma can have an allogeneic transplant. as well as marrow. Although a minority of patients have developed resistance to the drug. Because blood. Biomarkers could be high levels of certain substances in the body such as antibodies or hormones. This “graft versus leukemia or lymphoma effect” can suppress (cure) the malignancy and is a prolonged (indefinite) form of immunotherapy. decreased side effects. Most follow-up clinics specialize in pediatric cancer survivors. In nonablative transplantation. but some follow adult cancer survivors. “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. or genetic factors that can increase susceptibility to certain effects. making the procedure more tolerable. lymphoma or myeloma is attacked and suppressed by donor lymphocytes that form from the donor stem cells. To ensure there will be enough blood stem cells for successful transplantation. the donor’s cells take hold and the patient’s leukemia. Development of New Drugs: In the past decade. several important new drugs and new uses for existing drugs have greatly improved cure rates or remission duration for some patients with leukemia. The effectiveness and tolerance of older patients and the projections from the first five years of clinical trials in newly diagnosed patients suggest that the drug will prolong the duration of hematological remission and life when compared to former therapy. The protein is an enzyme in the family of tyrosine kinases. Adolescent. few severe adverse effects on normal tissues and a very high response rate. donors of blood stem cells require special treatment to mobilize sufficient stem cells from marrow into their blood before cells are harvested. 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. Cancer survivors should see their primary care physicians for general health examinations and an oncologist for follow-up care related to cancer. Coordination between specialists and primary care physicians is essential to provide the best care possible. Follow-Up Care Regular medical follow-up enables doctors to assess the full effect of therapy. In standard stem cell transplantation. lymphoma and myeloma. “Ablation” referred to wipingout the recipient’s cancer. 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.patients. the recipient’s blood cell and immune system are preserved. Stem cells not only reside in the marrow but also circulate in the blood. 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.

chronic eosinophilic leukemia (formerly hypereosinophilic syndrome). reducing the need for transfusions in some patients. approved by the FDA for all types of MDS. a less common type of chronic lymphocytic leukemia (CLL). This drug is also being tested in clinical trials to treat adult acute leukemia and MDS. Rituximab has become an important agent to treat CD20-positive lymphocytic malignancies. was approved by the FDA for newly diagnosed myeloma. Three types of immunotherapy are being explored: antibody treatment. 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. 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). the most prevalent lymphoma subtype. approved by the FDA in 2005. Gleevec is not only a very important new agent in the treatment of CML. In May 2006. LEUKEMIA page 4 LYMPHOMA MYELOMA . PDGFR or KIT oncoproteins). symptomatic anemia have improvement in hemoglobin levels with this agent. Other therapies in clinical research to treat MDS include arsenic trixoxide. In patients with anemia. Alemtuzumab (Campath®) is a monoclonal antibody directed against the antigen CD52 found on T and B lymphocytes. Patients with more severe forms of MDS are very unlikely to respond to the agent. has improved dramatically with the introduction of cladribine. The treatment of hairy cell leukemia. farnesyl transferase inhibitors and reduced-intensity stem cell transplantation. Food and Drug Administration [FDA] in 2006) and nilotinib (in clinical trials). lymphoma or myeloma. Cladribine induces long-term remissions in nearly 90 percent of patients treated at diagnosis for one week. kill unhealthy bone marrow cells and may help the bone marrow function more normally in MDS patients. thus rituximab is an anti-CD20 antibody. are entering clinical use and can overcome this resistance in some cases. 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.dasatinib (Sprycel®)(approved by the U. Monoclonal antibodies have added to the arsenal of agents that are used for the treatment of patients with lymphoma and leukemia. doxorubicin (Adriamycin®). Rituximab is an antibody directed at the target CD20 antigen on B-cell lymphoma cells. 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. Cell surface antigens have been given a cluster designation (CD) followed by a number. however. thalidomide (Thalomid®). and enhances the specificity of treatment to minimize toxic effects on normal tissues. 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®). Clofarabine (Clolar®). Pentostatin is another effective drug that can be used in patients with hairy cell leukemia who do not respond to cladribine. Some patients with moderately severe. and Decitabine (Dacogen®). perhaps 20 percent of cases also derive benefit. Revlimid is approved by the FDA in combination with dexamethasone for the treatment of myeloma patients who have received at least one prior therapy. Azacitidine (Vidaza®). Indeed. although initially used in indolent lymphomas. suppresses the progression of leukemia. but without this specific chromosome 5 abnormality. cyclophosphamide. such as follicular lymphoma. it has now become an important fifth drug in the R-CHOP–rituximab.S. a thalidomide derivative. in combination with dexamethasone. vincristine (Oncovin®) and prednisone–therapy for diffuse large B-cell lymphoma. Immunotherapy: This is a treatment that uses immune cells or antibodies to fight the disease. Arsenic trioxide also adds to the drugs available to treat this subtype of acute leukemia. Monoclonal Antibody Therapy: Monoclonal antibodies are laboratory-produced proteins that can be infused into an appropriate patient. It is especially active against the lymphocytes in CLL. principally. but it can also induce remissions in some cases of acute leukemia. immune cell administration and vaccine development. is being used to treat relapsed or refractory acute lymphocytic leukemia (ALL) in children who have received at least two prior therapies. Velcade is approved by the FDA for treating people with myeloma who have had at least one prior therapy. 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. 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.

The goal is to extend the duration of remission achieved by remissioninduction therapy of various types. is approved for older patients with AML who relapse after initial treatment. In one approach. gemtuzumab (Mylotarg®). gene therapy researchers are trying to modify an oncogene (BCR-ABL) that produces a protein that stimulates malignant cell growth. An alternative strategy called molecular targeted drug development targets the oncoprotein. If the gene in the former case is an oncogene or the protein in the latter case is an oncoprotein. myeloma and leukemia. Many cancer treatment vaccines under development are intended to induce antigen-specific antitumor immune responses. 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.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. Reversal of Multidrug Resistance: The malignant cells of patients have mechanisms that may allow them to escape the damaging effects of chemotherapy agents. DNA vaccines that contain the DNA that encodes the specific antigen are being tested. a technique that prepares small molecules in the laboratory that have the ability to inactivate proteins that cause disease. b) a modality that uses molecules of RNA to silence complementary (DNA) genes. The goal of several new agents being studied is to decrease resistance to an important chemotherapy drug used in leukemia. lymphoma and myeloma. In each case. These types of vaccines would be used in patients who have small amounts of residual blood cancer after chemotherapy or stem cell transplantation. In some approaches. less responsive to therapy. In studies of CML. 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. drugs are designed to interfere with the oncoprotein and prevent its effect on the cell. Studies of vaccines used in patients with follicular or indolent lymphoma have demonstrated an immune response. This drug. the patient’s immune cells would be treated in the laboratory to train them to attack the residual leukemia. or become. These drugs have been approved to treat relapsed B-cell non-Hodgkin lymphoma. 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. and aptamer treatment. some vaccines are made from leukemic cells treated in test tubes to convert them to potent antigen-presenting cells. In patients with CML who have relapsed after stem cell transplantation. lymphoma or myeloma cells. These are called conjugated monoclonal antibodies. These cells are. Two new and potentially important approaches include a) the application of RNA interference. 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. 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. They deliver the toxic substance directly to the cancer cells. Approaches to reversing multidrug resistance are under study. In another approach. 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. LEUKEMIA LYMPHOMA MYELOMA page 5 . new forms of cancer therapy may be developed. 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. Paradoxically. This means that the vaccine induces an immune response against the cancer cells present in the patient. Examples of this treatment are the drugs ibritumomab (Zevalin®) and tositumomab and iodine I131 tositumomab (Bexxar®). 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. 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. Patients with myeloma have also had remission re-induced by donor lymphocytes.

790).440 adults compared with 3.350 2. The four major types of leukemia are shown in Table 1.060 2.Leukemia Leukemia is a malignant disease (cancer) of the bone marrow and blood. red blood cells and white blood cells. functionless cells in the marrow and blood.440 Table 2: Sources: SEER (Surveillance. The incidence rates are usually presented as a specific number per 100.800 Female 2. each of which can be acute or chronic. • About 33 percent of cancers in children aged 0-14 years are leukemia • Most cases of chronic myelogenous leukemia (CML) occur in adults. and SEER Program.720 44.240 new cases of leukemia will be diagnosed in the United States this year. males are expected to account for 56 percent of the new cases of leukemia.570 3. released April 2007. Incidence by Gender Incidence rates* for all types of leukemia are higher among males than among females. 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 218.579 21. Epidemiology.960 7. Only 2. *Prevalence estimates are expressed here as the number of people living in whom the first involved tumor for each cancer site was diagnosed during the previous 29 years. aged 0-19.4 percent of leukemias in children aged 0-19 are CML. • Most cases of leukemia occur in older adults. and End Results) Cancer Statistics Review 1975-2004. In 2007.000 population. New Cases An estimated 44.S. functional cells to be made. a deficiency of red cells. NCI. Nearly 54 percent of the new cases of this disease will occur among children in 2007 (about 2. Prevalence database: U. A shortage of platelets results in bruising and easy bleeding. Table 3: Source: Cancer Facts & Figures 2007.289 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. Chronic leukemia progresses more slowly and allows greater numbers of more mature. more than half of all cases occur after age 67. Prevalence of the Four Major Leukemias as of Jan. Statistical Research and Applications Branch. *Note: Incidence rates are the number of new cases in a given year not counting the preexisting cases.S. based on the November 2006 SEER data submission. Surveillance Research Program. Acute leukemia is a rapidly progressing disease that results in the accumulation of immature. National Cancer Institute. American Cancer Society.) • The most common types of leukemia in adults are acute myelogenous leukemia (AML) and chronic lymphocytic leukemia (CLL). Leukemia is divided into four categories: myelogenous or lymphocytic. 2007.800 children.240 Male 3. Anemia. Estimated 29-Year L-D Prevalence Counts on 1/1/2004 by Duration. • The most common form of leukemia in children is acute lymphocytic leukemia (ALL).659 people in the United States are living with leukemia.570 19.410 4.380 6. develops in virtually all leukemia patients.501 50.189 27. Chronic leukemias account for 7 percent more of the cases than acute leukemias. DCCPS.340 13. 1.140 6. LEUKEMIA page 6 LYMPHOMA MYELOMA .000 2.200 15. (About 40. Approximate U.150 24.060 8. The lack of normal white cells impairs the body’s ability to fight infections. Leukemia is expected to strike more than 10 times as many adults as children in 2007.570 5. 2004 Type Chronic lymphocytic leukemia Chronic myelogenous leukemia Acute lymphocytic leukemia Acute myelogenous leukemia Prevalence* 95. 2007. It is characterized by the uncontrolled accumulation of blood cells. The marrow often no longer produces enough normal platelets.

Among 15. Hispanic children of all races under the age of 20 have the highest rates of leukemia.900 new cases of cancer diagnosed in African-Americans in 2007. CML incidence also increases dramatically among people who are aged 60 and older. the incidence of AML slowly rose while that of ALL steadily decreased in the period from late adolescence to older adulthood. Leukemia rates are substantially higher for Hispanic. Incidence by Age-Group Incidence rates by age differ for each of the leukemias. ALL incidence was approximately twice that of AML. Leukemia strikes all ages and both sexes. The cause of leukemia is not known. American Indian/Alaskan natives. Children. The American Cancer Society estimates that there will be approximately 152. Leukemia is one of the top 15 most frequently occurring cancers in minority groups. white and Asian/Pacific islander children than for black children. including the examination of the cells in blood or marrow. AML incidence was approximately 1. LEUKEMIA LYMPHOMA MYELOMA page 7 . The diagnosis of leukemia requires specific blood tests. Adolescents and Young Adults. These signs are not specific to leukemia and may be caused by other disorders. The incidence of ALL among 1. Adults. CLL incidence increases dramatically among people who are aged 50 and older. From 1975 to 2000. The leukemias represented 27 percent of all cancers occurring among children younger than 20 years from 2000-2004. In 25. including 3. Although chronic exposure to benzene in the workplace and exposure to extraordinary doses of irradiation can be causes of the disease. leukemia rates are higher in Americans of European descent than among those of African descent. 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. Most children under 15 years of age with ALL are cured.000 population. 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).922 cases per year. These cancers are most prevalent in the seventh. averaging about 189. However. 2007. was 504 per 100. from 2000-2004. Possible Causes of Leukemia Anyone can get leukemia. The most common form of leukemia among children under 20 years of age is ALL. Leukemia incidence is highest among whites and lowest among American Indians/Alaskan natives. and AML incidence increases dramatically in people who are aged 60 and older.5 times that of ALL. American Cancer Society. Some people with chronic leukemia may not have major symptoms and are diagnosed during a medical examination.619 with ALL. neither explains most cases. About 2.800 children will be diagnosed with leukemia throughout the United States. The incidence rate for all cancers among AfricanAmericans in the Seer (17 region). there were 4.to 19-year olds. It is estimated that in 2007. In the 17 SEER regions of the United States. eighth and ninth decades of life. Figure 3: Source: Cancer Facts & Figures 2007. They do warrant medical evaluation. 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.Estimated Proportion of New Cases (%) in 2007 for Each Type of Leukemia Including Adults and Children 3.to 4-year-old children is more than nine times greater than the rate for young adults ages 20 to 24.790 new cases of childhood ALL are expected to occur in 2007.to 29-year olds.799 children under the age of 20 diagnosed with leukemia from 2001-2004.

when compared to a person without leukemia. the overall relative survival rate was nearly 50 percent. 2000-2004 25 23. Complete remission means that there is no evidence of the disease and the patient returns to good health with normal blood and marrow cells. Treatment centers report increasing numbers of patients with leukemia who are in complete remission at least five years after diagnosis of their disease. The relative survival rates differ by age of the patient at diagnosis. 2007.1 for children under 15 • CML: 44. 54. Epidemiology and End Results) Cancer Statistics Review 1975-2004.000) 17 15. All Types Leukemia. Epidemiology and End Results) Cancer Statistics Review 1975-2004. and in 1996-2003.9 20-24 0. National Cancer Institute. a patient had a 14 percent chance of living five years.8 percent • AML: 20. During 1996-2003.4 <1 0. For acute leukemia. Relapse indicates return of the cancer cells and the return of other signs and symptoms of the disease.7 percent overall.3 percent overall.7 7 5 3 1 0 1.9 25-29 1.2 10.4 percent Five-Year Relative Survival Rates for All Ages.2 15 13 11 9 7.8 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. 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. Thirty-two percent more males than females are living with leukemia.8 1-4 0.4 5-9 0. In 1960-1963. LEUKEMIA page 8 LYMPHOMA MYELOMA . 90.2 1.6 2. National Cancer Institute. Treatment of Leukemia The aim of treatment is to bring about a complete remission.2 23 21 19 19.Age-Specific Incidence Rates for Acute Myelogenous Leukemia (All Races).3 3. The five-year relative survival rate has more than tripled in the past 47 years for patients with leukemia. By 1975-1977.6 10-14 0. 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. race and type of leukemia.1 4.1 Incidence (per 100. a complete remission (no evidence of disease in the blood or marrow) that lasts five years after treatment often indicates cure.4 percent for children under 5 • CLL: 74.5 21. the five-year relative survival rates overall were: • ALL: 65. 2007. the five-year relative survival rate had jumped to 35 percent.9 15-19 0.3 1. gender.

790 deaths in the United States will be attributed to leukemia in 2007: 12. 1975-2004.390 21. 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. Sources: 1. 2.970 250 2.470 Table 4: Source: Cancer Facts & Figures 2007.790 Male 820 2.Five-Year Relative Survival Rates for Acute Lymphocytic Leukemia. 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. LEUKEMIA LYMPHOMA MYELOMA page 9 . In 2007. Hispanics with leukemia who are under the age of 25 had the highest mortality rates from the disease between 1990 and 1999. leukemia causes more deaths than any other cancer among children and young adults under age 20. in Children Under 15 Years of Age.320 males and 9.680 12. Zuelzer WW. leukemia will be the fifth most common cause of cancer deaths in men and the sixth most common in women.500 deaths from CLL and 1. Cancer Statistics Review. unclassified forms of leukemia Total Overall 1.500 8. Blood.420 4.020 240 3. There will be an estimated 4. 1964:24:477-494. 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. National Cancer Institute. In 2007.990 490 6. Non-Hispanic whites diagnosed with leukemia over the age of 44 had the highest death rates during this period. Epidemiology and End Results). 2007.420 deaths from ALL. Implications of long-term survivals in acute stem cell leukemia of childhood treated with composite cyclic therapy. SEER (Surveillance. Unclassified forms of leukemia will account for 6. Despite this decline.470 females. about 515 children under the age of 14 are expected to die from leukemia. deaths from leukemia are expected to be distributed in the following numbers: In 2007.320 Female 600 1. Deaths It is anticipated that approximately 21.990 deaths from AML and 490 deaths from CML. 2007.940 3.390 additional deaths.710 9. American Cancer Society. African-Americans who were diagnosed with leukemia between the ages of 25 and 44 had the highest death rates from the disease during this period. There will be an estimated 8. 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.560 5.

eventually crowding out healthy cells and creating tumors that enlarge the lymph nodes or other sites in the body. New Cases of Lymphoma by Gender.266 members of the U. Living with Lymphoma In the United States in 2007.5 percent of all lymphomas diagnosed in 2007. while 0. or low. 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. Immune suppression plays a role in some patients.720 28. incidence rates for non. After 50 to 54 years of age. and each has prognostic factors that categorize it as more or less favorable. Both Hodgkin and non-Hodgkin lymphomas are more common in males than in females.190 71. These risk factors explain only a small proportion of cases.190 cases of non-Hodgkin lymphoma). More than four percent of all cases of Hodgkin lymphoma diagnosed in 2007 will be in children under 15 years of age.000 for females.000 for females.380 Americans will be diagnosed with lymphoma in 2007 (8. By ages 60 to 64. rose by 84 percent from 1975 to 2004.313 people living with Hodgkin lymphoma (active disease or in remission) and 405. Persons infected with the human immunodeficiency virus (HIV) have a much higher risk of developing lymphoma. The groups are often classified as indolent or aggressive. New Cases About 71. including the presence of an abnormal cell called the ReedSternberg cell (a large.190 cases of Hodgkin lymphoma and 63. they are 52.3 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. Hodgkin Lymphoma Hodgkin lymphoma is a specialized form of lymphoma and will represent about 11. The incidence of Hodgkin lymphoma is consistently lower than that of non-Hodgkin lymphoma. the difference was small.6 per 100.000 for males and 38. It is the sixth most common cause of cancer deaths in males and in females. Incidence rates for Hodgkin lymphoma tend to be higher among males than among females. an average annual percentage increase of 2.000 at ages 20 to 24 for males and 1. there are 138. Each histologic grouping is diagnosed and treated differently.380 Table 5: Source: Cancer Facts & Figures 2007.710 Total 8. population who are living with lymphoma. malignant cell found in Hodgkin lymphoma tissues).990 32. Hodgkin lymphoma has characteristics that distinguish it from all other cancers of the lymphatic system.9 per 100. in general whites have higher incidence rates than blacks.9 per 100. LEUKEMIA page 10 LYMPHOMA MYELOMA .470 34. In 2004. The Epstein-Barr virus causes Burkitt’s lymphoma in Africa.953 people living with nonHodgkin lymphoma for a total of 544. Lymphoma results when a lymphocyte (a type of white blood cell) undergoes a malignant change and begins to multiply. Age-specific incidence rates of non-Hodgkin lymphoma are 2.190 63.670 Female 3.S. 2007 Type Hodgkin lymphoma Non-Hodgkin lymphoma Total Male 4. Fifty-three percent of the blood cancers diagnosed are lymphomas.8 percent. 2007. American Cancer Society. The reasons for the development of non-Hodgkin lymphoma are not certain. Non-Hodgkin lymphoma is the fifth most common cancer in males and females in the United States.200 38. intermediate and high grade. Incidence by Gender Table 5 illustrates the breakdown of incidence of lymphoma by gender.Hodgkin lymphoma are higher in Americans of European descent than among those of African descent.7 percent of all cases of non-Hodgkin lymphoma will be diagnosed in children under 15 years of age this year. The bacterium Helicobacter pylori is associated with the development of lymphoma in the stomach wall.Lymphoma Lymphoma is a general term for a group of cancers that originates in the lymphatic system.

about 10.730 persons will die from lymphoma in the United States in 2007 (18. widespread disease requires chemotherapy or chemotherapy and/or monoclonal antibody therapy with radiation. Signs and Symptoms Signs and symptoms of Hodgkin lymphoma include painless swelling of lymph nodes in the neck. From ages 15 to 19. Non-Hodgkin lymphoma is the ninth most common cause of cancer death in males and the seventh in females in the United States. excessive tiredness. Adolescents are more commonly diagnosed with Hodgkin lymphoma than young children.5/1 million population). recurrent high fever. lymphomas are most commonly diagnosed in whites (24. The rate increases more than 18 times to 45. Lymphomas (Hodgkin lymphoma.000 people occur in 20. In children from 0 to 19 years of age. Symptoms also often include fever.0/1 million population). and is the eighth most common cause of cancer death in that group. Incidence in Children The incidence of Hodgkin lymphoma among people under 20 years of age was 1.000 by ages 60 to 64. 4. LEUKEMIA LYMPHOMA MYELOMA page 11 . Treatment Hodgkin lymphoma is often treated with radiation and chemotherapy.8 percent) and neoplasms of the brain and other nervous tissue (17. indigestion and abdominal pain. It has remained fairly constant since 1999.5 percent. The incidence in this group decreased almost steadily and significantly between 1975 and 1999. and more than 46-fold to 112.000 persons at ages 80 to 84. comprising nearly 5 percent of all cancers diagnosed.5 percent) are the third most common cancers in children. Death rates have been declining for Hodgkin lymphoma patients since the mid-1970s.000 children in 2004.Among women. the highest incidence of non-Hodgkin lymphoma is in Asian/Pacific islanders. chemotherapy or both may result in cures for most patients with Hodgkin lymphoma.1 per 100. Incidence in Adults The incidence of non-Hodgkin lymphoma increases with age. Even in the mid-1970s. Hispanics of all races have the second highest incidence rates of non-Hodgkin lymphoma after whites. The most common early sign of other forms of lymphoma is also painless swelling of the lymph nodes – usually in the neck. Five-year relative survival is now 95 percent for Hodgkin lymphoma in children aged 0 to 14 years. troublesome itching and weight loss.8 percent for all races in 1996-2003. In the United States.to 24year-old individuals.660 from non-Hodgkin lymphoma.4 cases per 100. most children with nonHodgkin lymphoma did not live five years after diagnosis. loss of appetite and bone pain. Survival for Adults Hodgkin lymphoma is now considered to be one of the most curable forms of cancer.1 cases per 100. cell type and location of the lymphoma. In children under 20 years of age. Hodgkin lymphoma incidence rates are higher in adolescents and young adults than in adults in their middle years. armpit. Treatment for non-Hodgkin lymphoma sometimes includes vaccines and other forms of immunotherapy. the highest incidence of non-Hodgkin lymphoma is in non-Hispanic whites. following leukemia (26. Radiation. The five-year relative survival rate for non-Hodgkin lymphoma patients has risen from 31 percent in whites in 1960-1963 to 63. and non-Hodgkin lymphoma. 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. About 2.9 percent). groin or in the abdomen. sweating at night.1 cases per 100. Non-Hodgkin lymphoma is the fifth most common cancer in Hispanics. persistent fatigue. Early stage. Survival for Children Five-year relative survival is 95. It is rarest among American Indian/ Alaskan native children. Deaths An estimated 19. This represents a significant improvement in the rate of recovery.070 from Hodgkin lymphoma). night sweats. localized non-Hodgkin lymphoma is sometimes treated with radiation.2 percent for Hodgkin lymphoma in people under 20 years of age. 1. five-year relative survival for non-Hodgkin lymphoma is now 83.400 children under the age of 15 will be diagnosed with cancer in 2007. 3. In children up to age 14 years.5 percent. depending on the tumor size. followed closely by Hispanic children of all races (24. armpit or groin.

3 4.6 32. *<16 cases per time interval.1 63.1 0.600 10.0 3.5 10. Epidemiology and End Results) Cancer Statistics Review 1975-2004.1 3. Age-Specific Incidence Rates for Non-Hodgkin Lymphoma.0 1.0 20 10 0 0.1 102.4 80.9 4.1 4.060 9. Epidemiology and End Results) Cancer Statistics Review 1975-2004. 2000-2004 6 Incidence (per 100.9 1.1 3. Epidemiology and End Results) Cancer Statistics Review 1975-2004.370 Female 300 9.2 1. American Cancer Society. 2007.4 2.9 3.6 0.3 <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.8 112. 2007.000) 5 4 3 2 1 0 0.4 2. National Cancer Institute.9 7.1 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. National Cancer Institute.4 4.4 2.0 100.730 Male 770 9.0 45.2 4.4 15. Table 6: Source: SEER (Surveillance.Age-Specific Incidence Rates for Hodgkin Lymphoma. 2007.4 3.8 3. 2007.000) 70 60 50 40 30 22. National Cancer Institute.0 0.660 19. * <16 cases for time interval.0 2. 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 1.360 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 100.8 2.4 2.070 18.8 4. LEUKEMIA page 12 LYMPHOMA MYELOMA .

2/100. • The median age at diagnosis for African-Americans is 67.4 33. Treatment Chemotherapy for myeloma has led to sustained remissions in some patients.3/100. especially in the marrow. Myeloma was the 10th most common cause of cancer deaths for women in 2000-2004.1 0.S. From 2000 to 2004. Figure 9: Source: SEER (Surveillance. and it rarely occurs in people under age 45. has been increasing.1 28.790 deaths from myeloma are anticipated this year.8 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) of myeloma than those of European descent (5. SEER 17 areas (<1.0 37. LEUKEMIA LYMPHOMA MYELOMA page 13 . Age-Specific Incidence Rates for Myeloma.5/100.7 1.1/100. The highest rates are found in black men 80 to 84 years of age and older (105/100. the cell that forms plasma cells.940 women) new cases of myeloma will be diagnosed in the United States in 2007. Sixty percent of those were diagnosed with the disease within the past four years. 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.1 5.1 Signs and Symptoms Often the first symptom of myeloma is bone pain caused by the effects of myeloma cells in the marrow. destroying normal bone tissue. Fractures may occur as a result of the weakened bones. The mortality rate from myeloma for people of African descent is more than double the rate for whites (7. Malignant plasma cells produce an abnormal protein called monoclonal immunoglobulin. Thalidomide is approved by the FDA for use in treating newly diagnosed myeloma. • The median age at diagnosis is 70. approximately double. New Cases An estimated 19. becomes malignant. Usually.Myeloma Myeloma is a cancer of the plasma cells. myeloma was the 10th most commonly diagnosed cancer among African-American men and women.000). the patient’s own stem cells are used (autologous stem cell infusion). It is 71 for African-Americans. Approximately 3 percent of all cancer-related deaths among AfricanAmericans in 2000-2004 were from myeloma. • Americans of African descent have a much higher incidence rate. especially. 1-4. tire more easily and feel weak. At times. 20-24). a type of white blood cell found in many tissues of the body. The onset of myeloma interferes with normal production of antibodies and makes myeloma patients susceptible to infections. causing pain and crowding out normal blood cell production.000) for all racial and ethnic groups.960 men and 8.000) 40 30 20 10 0 0-24 0.1 21.900 (10.000) is 56 percent higher than for women (4.424 people in the United States are living with myeloma.3 0.000). The U. Treatment is aimed at slowing progress of the disease. two or three drugs are used simultaneously. Recurrent infections may be an early sign of the disease. Lenalidomide is approved by the FDA in combination with dexamethasone for the treatment of myeloma patients who have received at least one prior therapy.9 9. • The incidence rate in men (7/100. Patients may have anemia.5 3. median age at death from multiple myeloma is 74. Deaths Approximately 10. *<16 cases for each age interval. Epidemiology and End Results) Cancer Statistics Review 1975-2004.5/100. National Cancer Institute. 15-19. a B lymphocyte. but primarily in the bone marrow.000 to 3. Living with Myeloma An estimated 60.4 35. 2007. but it is the most difficult blood cancer to treat successfully. 2000-2004 Incidence (per 100.000). 5-9. Total survival for white males. (11. 10-14. 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. In myeloma. Bortezomib has been approved for treating myeloma in patients who have had at least two prior therapies. It grows continuously and forms masses of plasma cells. Treatment may include intensive chemotherapy followed by stem cell transplantation to restore normal blood cell production.

9 5. National Cancer Institute. All Races.3 2.3 19. Lymphoma and Myeloma The following tables showing incidence rates for leukemia. (Based on SEER 17 areas.) Table 9: Source: SEER (Surveillance. 2007. 2007. per 100. for Whites.7 24.7 5.3 Male 13.5 Incidence Rates by Gender.0 7.) Incidence Rates by Gender.0 Female 9.2 6.1 9.000 Population (2000-2004) Type Leukemia Non-Hodgkin lymphoma Hodgkin lymphoma Myeloma Overall 12. per 100.4 4.0 Female 8. per 100.6 2.000 population and are age-adjusted to the 2000 population.) LEUKEMIA page 14 LYMPHOMA MYELOMA .6 4.8 14.1 11. Epidemiology and End Results) Cancer Statistics Review 1975-2004.0 23.Incidence Rates: Leukemia.000 Population (2000-2004) Type Leukemia Non-Hodgkin lymphoma Hodgkin lymphoma Myeloma Overall 10.2 18.8 20.9 17. for Blacks. the most recent available. 2007.5 Table 8: Source: SEER (Surveillance. Rates are per 100.6 Female 9. (Based on SEER 17 areas. Incidence Rates by Gender. Epidemiology and End Results) Cancer Statistics Review 1975-2004. National Cancer Institute.1 2.6 Male 16.2 2.2 Male 16.3 2. Epidemiology and End Results) Cancer Statistics Review 1975-2004.1 3.9 2.0 2.2 14.4 11.1 Table 10: Source: SEER (Surveillance.000 Population (2000-2004) Type Leukemia Non-Hodgkin lymphoma Hodgkin lymphoma Myeloma Overall 12. (Based on SEER 17 areas. Hodgkin and non-Hodgkin lymphoma and myeloma use figures from 2000-2004. National Cancer Institute.2 3.5 16.

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. 2006.030 910 620 420 680 680 250 630 1.190 880 870 170 100 4. Table 12: Sources: Cancer Facts & Figures 2007. **State estimates may not add up to U. Numbers are rounded to the nearest 10. Used with permission. Centers for Disease Control and Prevention.170 480 1.630 540 80 120 990 510 310 230 320 330 100 390 490 770 400 210 460 80 150 160 100 680 120 1. *Estimate is fewer than 50 cases.680 920 340 890 170 290 330 190 1.310 800 600 900 920 330 1. Note: These estimates are offered as a rough guide and should be interpreted with caution. CA A Cancer Journal for Clinicians.360 960 170 220 2.500 430 1.610 150 2.070 110 1. Numbers are rounded to the nearest 10. **State estimates may not add up to U. 2007.070 80 330 70 480 1. 2007 State Leukemia Non-Hodgkin Lymphoma Myeloma Hodgkin Lymphoma Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Dist. 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 2.830 240 230 60 * 1.520 310 3.710 570 500 2.Estimated New Cases of Blood Cancers by Site.140 60 260 80 410 1.260 220 400 420 290 2.880 240 250 50 50 1.240 170 550 130 800 3.550 * * * * *20 * * * * 60 * * * 50 * * * * * * * * * * * * * * * * * * 70 * * 50 * * 60 * * * * 80 * * * * * * * 390 Table 11: Sources: Cancer Facts & Figures 2007.140 380 140 1. and additional data supplied by the American Cancer Society.040 70 44. 2007 State Leukemia Non-Hodgkin Lymphoma Myeloma Hodgkin Lymphoma*** Estimated Deaths from Blood Cancers by Site. January/February 2007.660 210 * 190 120 1. total because of rounding and exclusion of estimates that are fewer than 50 cases.560 770 890 3.190 290 * 280 200 1.540 1. National Center for Health Statistics.160 140 50 360 440 170 320 * 18. American Cancer Society. *Estimate is fewer than 50 cases.300 110 63.080 1.360 610 * 950 290 260 1. ***Hodgkin lymphoma estimates are not available for 2007.130 300 80 900 960 300 1. Used with permission.S.180 4. which is new for 2007.530 1.410 560 * 740 230 230 930 70 300 50 350 1. is described by Pickle et al. American Cancer Society.S.610 670 610 110 60 3. Note: These estimates are offered as a rough guide and should be interpreted with caution.250 1. total because of rounding and exclusion of estimates that are fewer than 50 cases.510 500 60 70 900 380 220 160 280 430 100 370 460 730 310 170 400 70 110 120 80 650 120 1. numbers are small and NCI and ACS are having difficulty fitting them into the Pickle et al.240 740 80 1..670 1. 1969-2004. by State. 2007.070 Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Dist. They cannot be compared with previous years’ estimates to determine cancer incidence trends.080 600 7.370 100 * 430 380 130 350 * 19. 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 4.330 260 780 180 1.550 2. The method of derivation.030 570 * 610 210 360 1. LEUKEMIA LYMPHOMA MYELOMA page 15 . and additional data supplied by the American Cancer Society based on data from the U.010 1.150 290 270 70 * 1.160 1.410 130 50 500 490 130 490 * 21.370 250 280 2. model (see below). by State.300 470 90 100 750 430 300 220 290 310 110 320 420 660 350 170 500 80 110 130 90 600 120 1.390 1. Mortality Public Use Data Tapes.790 330 * 320 200 1.S.200 350 4.

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. CA A Cancer Journal for Clinicians. race or sex. January/February 2007. prevalence numbers reported may vary depending upon the method used to determine them. population) that belong to the National Program of Cancer Registries. so the exact number of cases is not known.S. Relative survival rate is an estimate of the percentage of patients who would be expected to survive the effects of the cancer. especially in looking at populations in which individuals have had more than one type of cancer. The data presented in this report are an extrapolation or estimate of the number of cases reported by the 17 Surveillance. Bureau of the Census’ 2000 population data for that region. may be incomplete in some cases and the data may reflect adjustments that anticipate changes that will occur once the actual data are received. Definitions Incidence is the number of newly diagnosed cases for a specific cancer or for all cancers combined during a specific time period. The American Cancer Society projects this year’s estimated cancer cases and deaths based on incidence rates for 1995 to 2003 from 41 states (approximately 86 percent of the estimated U. Epidemiology and End Results Program (SEER) regions (or. 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. Incidence rates can be calculated based on a number of factors such as age.” as per SEER table I-21. based on the “first invasive tumor for each cancer site diagnosed during the previous 29 years (1975-2003). In this report. estimates of cancer incidence. Thus. his or her survival with leukemia may not be counted in leukemia prevalence statistics. When expressed as a rate. 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.) Prevalence is the estimated number of people alive on a certain date in a population who previously had a diagnosis of the disease. (Observed survival is the actual percentage of patients still alive at some specified time after diagnosis of cancer. Census. Because of this change in method. The SEER (17 region) data cover only about 26 percent of the U. cancer or otherwise. 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.S. population. it is the number of new cases per standard unit of population during the time period. The relative survival rate is a comparison of survival to a person who is free of the disease. This change means that the 2007 incidence estimates are not comparable with previous estimates for determining cancer incidence trends. survival and mortality have been revised. the data presented in the 2007 SEER report placed online on April 15.. Prevalence may be calculated in a number of different ways. 2007. This year. but these figures do not take into account differences in geography. if a person is initially diagnosed with melanoma and later develops leukemia. the American Cancer Society changed its method of estimating cancer incidence. Thus. It considers deaths from all causes. mostly upward. no matter how long ago that diagnosis was. race and ethnicity in various regions and region-specific health risks. only the first diagnosed cancer counts. The specified date is 1/1/2004 for the prevalence estimates.” We are using the “29-year limited duration” prevalence figures. It includes new (incidence) and preexisting cases and is a function of both past incidence and survival. Because of reporting delays from some of the SEER regions. The data can be extrapolated for the entire United States by multiplying by the population ratio.S. Because of changes in the information — such as racial classification — gathered in the 2000 U. in comparison to the 2002 SEER report. In some prevalence statistics. in some cases fewer than 17 SEER regions) and death data from the National Center for Health Statistics. 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.S. LEUKEMIA page 16 LYMPHOMA MYELOMA . state-by-state data for incidence of Hodgkin lymphoma are not available because these numbers are so small.Notes and Definitions Notes The United States does not have a nationwide reporting system or registry for blood cancers. The description of the methods used was published in Pickle et al.

” Pickle LW. Cheson B. and End Results) Cancer Statistics Review. Ross J. “Cancer Statistics.” Bleyer A. CA A Cancer Journal for Clinicians Vol. Epidemiology. and End Results (SEER) Program. Howlander N. Bethesda.org/cgi/content/full/57/1/30. In Cancer Epidemiology in Older Adolescents and Young Adults 15 to 29 Years of Age. Ries LAG (eds). January. Atlanta: American Cancer Society. pp. No. Including SEER Incidence and Survival: 1975-2000. Miller BA. Ries LAG (eds). National Cancer Institute. “Leukemias. Sheaffer J. 065767.Citations Source Citations Cancer Facts & Figures 2007. Krapcho M. http://caonline. 39-51. pp. Tiwari RC. 57. MD. Bethesda. Barr R. 2006. 2007. Howe HL. In Cancer Epidemiology in Older Adolescents and Young Adults 15 to 29 Years of Age. Jemal A. pp. Zou Z. 20-37. O’Leary M. 1975-2004. Reichman M.gov/csr/1975_2004/ LEUKEMIA LYMPHOMA MYELOMA page 17 . Cancer Facts & Figures for African Americans 2007-2008. SEER (Surveillance.cancer. NIH Pub.” Hayat MJ. Shu X-O. “A New Method of Estimating United States and State-Level Cancer Incidence Counts for the Current Calendar Year. National Cancer Institute. Including SEER Incidence and Survival: 1975-2000. Hachey M. Melbert D. Atlanta: American Cancer Society. Clegg L. Bleyer A. Keller F. Bethesda. The Oncologist Vol. Stock W. 2006. Edwards BK. Bleyer A. O’Leary M. Ries LAG. 30-42. Ward E. Howlader N. Eisner MP.com/cgi/content/full/12/1/20. Barr R. National Cancer Institute. 25-38. January/February. Trends. Barr R. Bleyer A. “Highlights and Challenges. Mariotto A. 2006. pp. Nachman J. p. Epidemiology. 174. Bethesda. http://www. Hao Y. 06-5767. No.” Mattano L Jr. Barr R. Ries LAG (eds). MD. No. 2007. NIH Pub. National Cancer Institute. Including SEER Incidence and Survival: 1975-2000. 2007. and Multiple Primary Cancer Analyses from the Surveillance. NIH Pub.TheOncologist. Edwards BK (eds). posted to the SEER Web site 2007. 12. based on November 2006 SEER data submission. Feuer EJ. MD. “Lymphomas and Reticuloendothelial Neoplasms. Reichman ME. http://seer. 065767. Feuer EJ. 2007.” O’Leary M. In Cancer Epidemiology in Older Adolescents and Young Adults 15 to 29 Years of Age. Horner MJ. MD.amcancersoc. O’Leary M.

000 a year for a total of $150. 3) Translational Research Program. lymphoma and myeloma should be encouraged worldwide. Research grants are awarded in three program areas: Career Development. They are: 1) Career Development Program (CDP)-basic research. • Special Fellows in Clinical Research are awarded $60.25 million. are granted each year.000 a year for a total of $180. or control of. Translational Research Awards are made for an initial three-year period. Now supporting $61. • Special Fellows are awarded $60.000 over three years. lymphoma or myeloma. Translational Research • Scholars in Clinical Research are awarded $110. lymphoma and myeloma that is intended to advance treatment. Translational Research Program The Translational Research Program provides early-stage support for research on leukemia. the Society’s grant programs are among the most prestigious in the fields of blood cancers. 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 Grant Review Process Scientists and physician-scientists who are experts in the field of leukemia.000 over three years. lymphoma and myeloma research comprise four review subcomittees. Funding for two additional years may be provided for highly promising projects that are entering phase I clinical trial. treatment or prevention of leukemia.25 million per year over a five-year period.000. diagnosis or prevention in the near term.000 a year for a total of $180.000 a year for a total of $550. research reaching a clinical trial can receive $1 million over five years to facilitate new drug discovery or advances in diagnosis or prevention. The Specialized Center of Research (SCOR) in Leukemia. The SCOR grants also support scientific core laboratories to provide access to innovative technology if required by the participating research programs. for a total of $600.000 over five years. Each SCOR is funded up to $1. to a total cost of $6. 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 and the Specialized Center of Research (SCOR). each focused on the discovery of new approaches to benefit patients or those at risk for developing leukemia. the Society has awarded more than $550 million in research grants. The participating scientists may be at different institutions or from any country. 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. 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. lymphoma and myeloma. We offer a wide variety of programs and services in support of our mission: Cure leukemia. lymphoma.000 over five years. leukemia. Since the first funding in 1954. and improve the quality of life of patients and their families. 2) CDP-clinical research. Awards go to those groups that best demonstrate the synergy that will occur from their close interaction. The program is expected to generate new knowledge and breakthrough discoveries.000 over three years. Career Development Program The Career Development Program supports promising young scientists (Scholars. • Fellows are awarded $50.About the Society The Leukemia & Lymphoma Society is the world’s largest voluntary health organization dedicated to funding blood cancer research and providing education and patient services. The SCOR program brings together research teams working in complementary areas. Thus.000 a year for a total of $550. Hodgkin’s disease and myeloma. The Society is a nonprofit organization that relies on the generosity of individual and corporate contributions to advance its mission.000 per year for three years. leading to better survival rates and prevention measures for patients.6 million annually on research. Awards up to $200.

is held each December on the Friday immediately before the American Society of Hematology meeting. and applications for the Society’s three research programs may be obtained by visiting www. Guidelines. Information specialists are oncology social workers and health educators who provide callers with current information on blood cancers.org. As of June 30. myelodysplastic syndromes (MDS) and other blood cancers. ET.org. Guided by two volunteer oncology health professionals. instructions.m. Monday through Friday. Each year. www.org. and click “Live Help. Family Support Group locations.org. Much of the content of these materials is available to view and download at www. ET. This support should advance the understanding. and encourages greater communication among patients.org or by or emailing researchprograms@LLS. on the Society’s Web site. treatments. A trained patient volunteer currently in remission phones the new patient to share information and support. The Annual Research Symposium. 9 a. where medical professionals share the latest research findings. 2007 the Society will have 379 active grantees at 116 institutions in the United States and abroad. brochures and videos through the IRC and local Society chapters.LLS. www. Patients. 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.m. serves a wide variety of education and information needs. families and professionals may call the IRC toll free at (800) 955-4572 in addition to corresponding by email at infocenter@LLS. families. www.important projects to advance the Society’s mission. friends and healthcare professionals. audio. These offices conduct lifeenhancing patient services. Other meetings are held for the Society’s grantees.org. These include the Stohlman Scholar Symposium.org/copay.org. The educational program offers varying formats to facilitate the exchange of information and ideas on the newest developments in cancer research and treatment.m.LLS. to 6 p. The user has the opportunity to create personalized pages with identified interests. lymphoma. 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. their families and healthcare professionals.LLS. It is continually being updated and expanded to support and promote the Society’s mission. LEUKEMIA LYMPHOMA MYELOMA page 19 . peer counseling and patient financial aid.org or faxing to (914) 949-6691 or contacting the Research Department at (914) 949-5213. podcasts and Webcast archives of these programs are available at www. The Society funds several Focused Workshops each year on important topics relevant to hematological malignancies.m. clinical trials and offer guidance on coping. Co-Pay Assistance Program Patients with AML. Patient Services The Society has a network of 68 chapters throughout the United States and Canada. They are available to talk one-onone. lymphoma and myeloma. Patients needing assistance may apply on the Society’s Web site. The IRC is a worldwide link to information and resources useful to patients. the Society distributes more than 1 million booklets. 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. each group provides information and support. 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. Information on registration for these free events can be accessed at www.LLS. to 5:00 p. including support groups. The site features a comprehensive overview of blood cancers. treatment and prevention of leukemia. the Society’s programs and services. sponsored by the Society.LLS. information about our peer-to-peer program First Connection and other programs.LLS. The Society’s Web Site The Society’s Web site. from 10:00 a. First Connection: This program links newly diagnosed patients to a peer volunteer who has experienced a similar diagnosis.LLS.org. Teleconferences and Webcasts The Society sponsors more than 25 educational teleconferences and Webcasts each year on topics of interest to patients and caregivers. lymphoma. The Society also hosts numerous teleconferences and Webcasts. myeloma. call (877) LLS-COPAY ([877] 557-2672) or email copay@LLS.

and offers numerous resources that can assist childhood cancer survivors to flourish in the school environment posttreatment. New Directions in Myeloma Therapy: This program presents an overview of myeloma. emerging therapies and side effects and addresses the unique challenges of nursing management of these patients. The Trish Greene Back to School Program for Children with Cancer: This program is designed to increase communication among healthcare professionals. In 2001. DC. Patient financial aid funds are subject to availability. patients and school personnel to assure youngsters a smooth transition from active treatment back to school. risk factors. treatments. This program is provided through an unrestricted educational grant from Millennium Pharmaceuticals. On the state level. LEUKEMIA page 20 LYMPHOMA MYELOMA . diagnosis. treatments. CML Issues and Insights: A Nursing Education Program on Chronic Myelogenous Leukemia. In 2002. This nursing education program provides an overview of CML.Patient Financial Aid Program: For more than 31 years. providing additional support for blood cancer patients and their families nationwide. New insights. The Path to Progress: Clinical Trials in Blood Cancers: This program provides patients. videos and other materials to aid the process are available through all local chapters. That network now numbers more than 35.LLS. Society volunteers and staff visit Capitol Hill regularly to lobby Congress in support of issues that impact research and patient care. how cancer drugs are developed and what the emerging treatment options are for leukemia. It is supported by Amgen Oncology. Advocacy Since 1994. the Society’s advocacy program has been a strong voice in Washington. parents. representing to policy makers at all levels of government the healthcare quality concerns and medical research interests of patients and their families. reimbursement of up to $500 per year helps cover the costs of transportation.000 and has become a potent voice in public policy deliberations.org and is being sponsored by a generous. This program is also accessible as a Webcast at www. This program is made possible by the Lance Armstrong Foundation.S. drugs and various treatments not covered by insurance.and long-term effects that children may experience after treatment. Meet the Expert on Non-Hodgkin Lymphoma: This program presents basic information on terminology. lymphoma and myeloma. 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. families and healthcare professionals with a clear description of what clinical trials are. To date. unrestricted educational grant from Genentech BioOncology and Biogen Idec Inc. This Society program is being supported by Celgene Corporation and Millennium Pharmaceuticals. emerging therapies and managing side effects and how to find emotional support when living with the illness. Printed literature. Welcome Back: Facilitating the Return to School for Children with Cancer: A new addition to The Trish Greene Back to School Program. 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. that program has funded some $30 million in additional blood cancer research. treatments and future directions for NHL are also discussed. the Society has helped patients demonstrating a need for financial assistance cover a portion of their treatment costs. 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. 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. staging and classification of nonHodgkin lymphoma (NHL). Through the Patient Financial Aid Program. The patient education program was funded at $18 million through 2007. Department of Defense’s medical research program. This program is being sponsored by an unrestricted education grant from Novartis Oncology. Working through chapters across the country. the Society successfully lobbied Congress to institute a blood cancer research initiative as part of the U. The Society has identified key issues that currently shape its advocacy agenda. 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. this education program discusses possible emotional and cognitive short.

provided ACS’s state-by-state statistics on myeloma and Hodgkin lymphoma. Ph.seer. Milton Eisner of SEER.Acknowledgements Additional data from SEER*Stat Databases at http://www..gov.D. and Rebecca Siegel. . The Leukemia & Lymphoma Society extends special thanks to Myrna Watanabe.cancer. of the American Cancer Society (ACS). with the understanding that the Society is not engaged in rendering medical or other professional services. This publication is designed to provide information in regard to the subject matter covered. NCI. It is distributed as a public service by The Leukemia & Lymphoma Society Inc. provided statistical assistance. for compilation of data for this publication.

org Our mission: Cure leukemia. New York 10605 Tel: 888.HELP. and improve the quality of life of patients and their families.Home Office 1311 Mamaroneck Avenue.LLS.LLS Information Resource Center (IRC): 800. The Society is a nonprofit organization that relies on the generosity of individual.955. Suite 310 White Plains. Hodgkin’s disease and myeloma.4572 www. corporate and foundation contributions to advance its mission. PS80 35M 6/07 . lymphoma.

Sign up to vote on this title
UsefulNot useful