A Snapshot of Leukemia
Incidence and Mortality
Leukemia, the second most common blood cancer after lymphoma, includes several diseases. The four major types are acute lymphocytic leukemia (ALL), chronic lymphocytic leukemia (CLL), acute myelogenous leukemia (AML), and chronic myelogenous leukemia (CML). Although leukemia occurs most often in older adults, it is among the most common childhood cancers. ALL accounts for approximately 75 percent of all childhood leukemias. By contrast, the most common types of leukemia in adults are AML and CLL, followed by ALL and CML.
The overall incidence rates for leukemia have increased on average 0.2 percent each year from 2002 to 2011, while overall mortality rates have fallen an average of 1 percent each year from 2001 to 2010. Incidence and mortality rates are higher in whites than in people of other racial and ethnic groups. Leukemia is slightly more common in men than women.
Specific risk factors for leukemia depend on the type of leukemia. In general, increased risk is associated with being male, smoking, exposure to certain chemicals such as benzene, exposure to radiation, past treatment with chemotherapy or radiation therapy, having certain inherited or genetic disorders, having certain blood disorders, and having a family history of leukemia. There are no standard screening tests for leukemia. Depending on the type of leukemia, standard treatments include watchful waiting, chemotherapy, targeted therapy, radiation therapy, and stem cell transplant.
Assuming that incidence and survival rates follow recent trends, it is estimated that $5.9 billion1 will be spent on care for patients with leukemia in the United States in 2014.
Examples of NCI Activities Relevant to Leukemia
- NCI’s Familial Chronic Lymphocytic Leukemia Study is studying families with multiple cases of CLL to find the gene or genes that cause CLL in these families, to describe the clinical features of familial CLL, to determine whether families prone to CLL are at greater risk for other kinds of leukemia or cancer, and to identify markers that predict risk in family members.
- The Epidemiology and Genomics Research Program supports research and resources focusing on interdisciplinary and translational cancer research, including two epidemiology consortia focused on leukemia:
- The Childhood Leukemia International Consortium coordinates collaborative research examining the roles of clinical, infectious, environmental, and genetic risk factors in the etiology of childhood leukemia.
- The Chronic Lymphocytic Leukemia Research Consortium is a multi-institutional collaboration that coordinates research on the origins of CLL and seeks to identify new treatments for patients with CLL.
- The Blood and Marrow Transplant Clinical Trials Network conducts large multi-institutional clinical trials that address important issues in hematopoietic stem cell transplantation to improve outcomes for patients with leukemia.
- Researchers with The Cancer Genome Atlas (TCGA) program are systematically identifying the major genomic changes involved in more than 20 cancers, including AML, using state-of-the-art genomic technologies. Additionally, the TCGA Pan-Cancer analysis project is comparing mutations across tumor types to identify genomic similarities; such similarities could raise the prospect that similar treatments could be useful for multiple cancer types. [PubMed Abstract]
- The Lymphoid Malignancies Branch conducts translational research on the regulation of the immune response and disorders of the immune system that underlie immunodeficiency and diseases such as leukemia and lymphoma.
- Three leukemia-specific Specialized Programs of Research Excellence (SPOREs) are identifying novel targets for leukemia therapy, causes of resistance to chemotherapy, and genetic risk factors for CLL and AML.
Selected Advances in Leukemia Research
- A screen of FDA-approved drugs, small molecules, and natural products identified a 50-year-old antipsychotic medication called perphenazine, as a drug that can induce apoptosis in zebrafish, mouse, and human cell models of T-cell acute lymphoblastic leukemia (T-ALL), suggesting therapeutic potential in patients. Published January 2014. [PubMed Abstract]
- DNA sequencing of hairy cell leukemia (a rare subtype of CLL) samples revealed a high prevalence of mutations in the oncogene encoding the kinase MEK1, suggesting potential new treatment strategies targeting MEK1. Published January 2014. [PubMed Abstract]
- A methylation “signature” (chemical changes in DNA that turn genes on or off) in the DNA of blood-forming stem cells was able to predict which AML patients were likely to benefit more from chemotherapy and have better overall survival. Published February 2014. [PubMed Abstract]
- In preclinical studies, the investigational agent MLN4924 disrupted an important cell survival and chemoresistance pathway in CLL cells. Published March 2014. [PubMed Abstract]
Trends in NCI Funding for Leukemia Research
NCI’s investment2 in leukemia research was $234.9 million in fiscal year (FY) 2013. In addition to the funding described in the graph, NCI supported $53.1 million in leukemia research in FYs 2009 and 2010 using funding from the American Recovery and Reinvestment Act.
Additional Resources for Leukemia
- What You Need To Know About™ Leukemia
Describes possible risks, symptoms, diagnosis, and treatment for someone recently diagnosed with leukemia.
- Leukemia Home Page
NCI's gateway for information about leukemia.
- Adult Acute Lymphoblastic Leukemia Treatment (PDQ®)
Expert-reviewed information summary about the treatment of adult acute lymphoblastic leukemia.
- Adult Acute Myeloid Leukemia Treatment (PDQ®)
Expert-reviewed information summary about the treatment of adult acute myeloid leukemia.
- Chronic Lymphocytic Leukemia Treatment (PDQ®)
Expert-reviewed information summary about the treatment of chronic lymphocytic leukemia.
- Chronic Myelogenous Leukemia Treatment (PDQ®)
Expert-reviewed information summary about the treatment of chronic myelogenous leukemia.
- Hairy Cell Leukemia Treatment (PDQ®)
Expert-reviewed information summary about the treatment of hairy cell leukemia.
- Clinical Trials for Adult Acute Lymphoblastic Leukemia
- Clinical Trials for Adult Acute Myeloid Leukemia
- Clinical Trials for Chronic Lymphocytic Leukemia
- Clinical Trials for Chronic Myelogenous Leukemia
- Clinical Trials for Hairy Cell Leukemia Treatment
- 1 Cancer Prevalence and Cost of Care Projections, in 2010 dollars.
- 2 The estimated NCI investment is based on funding associated with a broad range of peer-reviewed scientific activities. For additional information on research planning and budgeting at the National Institutes of Health (NIH), see About NIH.