A Snapshot of Leukemia

Incidence and Mortality

Leukemia, the most common blood cancer, includes several diseases. The four major types are acute lymphocytic leukemia (also called acute lymphoblastic leukemia, ALL), chronic lymphocytic leukemia (CLL), acute myelogenous leukemia (AML), and chronic myelogenous leukemia (CML). Although approximately 10 times more adults than children have leukemia, it is the most common cancer among children, with ALL accounting for approximately 75 percent of all childhood leukemias. The most common types of leukemia in adults are AML and CLL, followed by CML and ALL.

The incidence rates for leukemia have remained relatively steady over the last 20 years, while the mortality rates have decreased and are higher in whites than in people of other racial/ethnic groups. Overall, men are more likely to develop leukemia than are women.

Risk factors for leukemia include smoking, exposure to certain chemicals such as benzene, exposure to radiation, past treatment with chemotherapy or radiation therapy, having certain inherited diseases or blood disorders, and family history. There are no standard screening tests for leukemia. Depending on the type of leukemia, standard treatments include watchful waiting, chemotherapy, targeted therapy, biological therapy, radiation therapy, surgery, donor lymphocyte infusion, and chemotherapy with stem cell transplant.

It is estimated that approximately $5.4 billion¹ is spent in the United States each year on leukemia treatment.

Trends in NCI Funding for Leukemia Research

The National Cancer Institute's (NCI) investment² in leukemia research increased from $205.5 million in fiscal year (FY) 2007 to $239.7 million in FY 2010, before decreasing to $227.0 million in FY 2011. In addition to this funding, NCI supported $53.1 million in leukemia research in FY 2009 and 2010 using funding from the American Recovery and Reinvestment Act (ARRA)³.

Examples of NCI Activities Relevant to Leukemia

• NCI's Familial Chronic Lymphocytic Leukemia program is studying families with multiple cases of CLL to find the gene or genes that cause CLL in these families, determine whether families prone to CLL are at greater risk for other kinds of leukemia or cancer, and identify markers of risk in family members.
• The Lymphoma/Leukemia Molecular Profiling Project is examining the gene expression profiles of lymphoid malignancies to refine their classification. Another goal is to use gene expression data for prognosis and to select treatment.
• The Childhood Leukemia International Consortium coordinates collaborative research on the role of infectious, environmental, and genetic risk factors in the etiology of childhood leukemia. The Chronic Lymphocytic Leukemia Research Consortium is a multi-institutional project that coordinates research on understanding the origins of CLL and identifying 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.
• The Integrative Cancer Biology Program combines experimental and clinical research with mathematical modeling to gain new insight into the biology, prevention, diagnosis, and treatment of cancer, including AML and ALL.
• The Special Translational Research Acceleration Projects (STRAP) initiative provides supplemental funding to move basic science discoveries to the point of early clinical trial testing. One project is exploring methods to improve the function of modified T cells to treat patients with persistent leukemia after chemotherapy.
• Two 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

• Researchers treated a CLL patient using immunotherapy by modifying his T cells to express a protein that caused his immune cells to attack the cancer, resulting in complete response three weeks post-treatment. Published August 2011. [PubMed Abstract]
• A retrospective study of cancer cells isolated from a clinical trial cohort of AML patients used mutational profiling of 18 genes to identify genetic alterations that may predict patient prognosis and likelihood of responding to certain treatments. Published March 2012. [PubMed Abstract]
• A whole-genome sequencing study of skin and bone marrow samples from seven patients has provided clues to the genetic evolution of AML that arises in patients previously diagnosed with a myelodysplastic syndrome. Reported March 2012.
• Researchers identified mutations in a protein called FLT3 that may serve as useful targets for the development of new drugs for some patients with AML. Published April 2012. [PubMed Abstract]
• See this PubMed list of selected free full-text journal articles on NCI-supported research relevant to leukemia. You can also search PubMed for additional scientific articles.

• ¹ Cancer Trends Progress Report, 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.
• ³ For more information regarding ARRA funding at NCI, see Recovery Act Funding at NCI.
• ⁴ Scientific Area Codes
• ⁵ NCI Funded Research Portfolio