High Incidence of Chronic Myelogenous Leukemia in Kitsap County and Puget Sound Naval Shipyard

First authored in 1996

I am writing this because of the concern I have over what I perceive to be a very high rate of Chronic Myelogenous Leukemia (CML) in Kitsap County (pop approx. 207,800) and the Puget Sound Naval Shipyard (12,000 workers - 1990 to 1993). In February of 1993, I was diagnosed with CML. In September of 1993, I had a bone marrow transplantation (BMT) at the Fred Hutchinson Cancer Research Center, Seattle, WA. (CML is not cured except with a BMT). Since then, I have belonged to a local cancer support group. There are five of us post BMT CML survivors in my support group (Al McFarland (diagnosed 12/90; BMT 7/91), Terri (BMT 1/93), Heather, Jan (BMT 2/93) and Bob Farmer- me (diagnosed 2/93; BMT 9/93). Three of us live within a mile radius of each other. Terri lives one block from me and Al lives about two miles away.

hutchnews.jpg (15341 bytes)
Printed in the June 4, 1998
Center News
Fred Hutchinson Cancer Research Center

The following are the reasons and logic behind my concern:

Robert F. Farmer
Bremerton, WA

Calculations using the reference data assumptions.

Table 1. Incidence of CML in Puget Sound Naval Shipyard, Dec 1991 to Feb 1993 with 20% of known survivors with a 60% leukemia free survival (LFS) rate.
PSNS - predicted outcome (20% known with 60% LFS)
BMT survivors total 3
BMT survival rate 60%
Pre BMT 5
% who do BMT 20%
2.16 year total (26 months) 25
1 year average 11.57
Population base 12,000
Incidence per 100K 96.5
National average per 100K 1.4
Times above the national average 68.9
This is 2.75 to 3.4 times worse than Hiroshima and Nagasaki
Atomic bomb survivors after the explosion of Hiroshima and Nagasaki had a 20-25 fold increase in the incidence of leukemia.

Table 2. Incidence of CML in Puget Sound Naval Shipyard, Dec 1991 to Feb 1993 with 100% of known survivors with a 100% leukemia free survival (LFS) rate.
PSNS - best outcome (100% known with 100% LFS)
BMT survivors total 3
BMT survival rate 100%
Pre BMT 3
% who do BMT 100%
2.16 year total (26 months) 3
1 year average 1.39
Population base 12,000
Incidence per 100K 11.6
National average per 100K 1.4
Times above the national average 8.3

Table 3. Incidence of CML in Kitsap County, Dec 1991 to Feb 1993 with 20% known survivors with a 60% leukemia free survival (LFS) rate.
Kitsap County - predicted outcome (20% known with 60% LFS)
BMT survivors total 5
BMT survival rate 60%
Pre BMT 8.3
% who do BMT 20%
2.16 year total (26 months) 41.7
1 year average 19.29
Population base 207,800
Incidence per 100K 9.3
National average per 100K 1.4
Times above the national average 6.6

References:
(a) California rate for CML is 1.3 per 100,000 per year for CML
Source:
Table 1. Average Annual Age-Adjusted (1970 US Standard) Invasive Cancer Incidence Rates per 100,000 Population by Primary Site, Race/Ethnicity and Sex
http://cedr.lbl.gov/~houser/cancer/calif94/t1.html
(b) National rate for CML is 1.4 per 100,000 (4,200 per yr)
Source:
National Cancer Institute
NIH Publication Number 94-329
Revised November 1993
Table 2. Leukemia Statistics
NCI/PDQ Cancer News: - Modified
 
(c ) Total per year in USA aprox 5,000 year
Source:
BMT Newsletter story on BMT for Leukemia
January 1995
Issue # 28 - BMTs for Chronic Myelogeneous Leukemia
http://nysernet.org/bcic/bmt/march1995/lead-story.html
(d) Slightly over 1000 Allogeneic BMT for CML in North America for 1995
Source:
International Bone Marrow Transplant Registry
http://www.biostat.mcw.edu/IBMTR/slides.html
Slide 4: Indications for blood and marrow transplants in North America, 1995
http://www.biostat.mcw.edu/IBMTR/gifs/Slide_4.GIF
 
(e) Other
Slide 8: Probability of Leukemia-free Survival after HLA-identical Sibling BMT for Chronic Myelogenous Leukemia, 1989-1995
http://www.biostat.mcw.edu/IBMTR/gifs/Slide_8.GIF

I welcome your comments and suggestions.
Bob Farmer - robert.farmer@comcast.net

Last Updated on 05/25/04