Global burden and trend of acute lymphoblastic leukemia from 1990 to 2017

Abstract

Acute lymphoblastic leukemia (ALL) is a common malignant hematologic disease that is characterized by large numbers of dedifferentiated lymphoid cells. Statistical data of ALL's incidence and mortality are fundamental for policymakers to allocate resources optimally. In this study, we reported the incidence, death, and disability-adjusted life year (DALY) of ALL in the globe from 1990 to 2017. Our analysis showed that the incidence case of ALL increased by 30.81%, while the age-standardized incidence rate (ASIR) maintained stable. Subgroup analysis by social-demographic index (SDI) showed that ALL's ASIR was significantly decreased in high SDI countries, but were moderately increased in high-middle SDI countries. The change trends of age-standardized death rate and DALY rate were similar to ASIR trends. Subgroup analysis by age groups showed that children and the elderly were more likely to suffer ALL. Risk factor analysis demonstrated that smoking was the most significant contributor to ALL's death and DALY in the globe. Besides, the high body-mass index is playing an increasingly important role in ALL-caused mortality. Multiple methods to counteract potential risk factors should be adopted, such as controlling body-mass index in all regions and avoiding occupational exposure to carcinogens in low SDI countries.

Keywords: acute lymphoblastic leukemia; cancer risk factor; cancer statistics; global burden of disease; social-demographic index.

Figure 1

The change trends of ASIR, ASDR, and age-standardized DALY rate. ASIR of total population (A), male (B), and female (C); ASDR of total population (D), male (E), and female (F); age-standardized DALY rate of total population (G), male (H), and female (I). SDI: Socio-demographic Index; ASIR: age-standardized incidence rate; ASDR: age-standardized death rate; EAPC: estimated annual percentage change.

Figure 2

The global disease burden of ALL in 195 countries or territories. (A) The ASIR of ALL in 2017. (B) The relative incidences change of ALL between 1990 and 2017. (C) The EAPC of ALL's ASIR from 1990 to 2017. ASIR: age-standardized incidence rate; EAPC: estimated annual percentage change.

Figure 3

The correlation between EAPCs and SDI in 2017. (A) The correlation of ALL's EAPC of ASIR and SDI in 2017. (B) The correlation of ALL's EAPC of ASDR and SDI in 2017. (C) The correlation of ALL's EAPC of age-standardized DALY rate and SDI in 2017. One circle refers to one country, and the size of the circle reflects the quantity of ALL cases. SDI: Socio-demographic Index; ASIR: age-standardized incidence rate; ASDR: age-standardized death rate; EAPC: estimated annual percentage change;

Figure 4

The change trends of ASRs and SDI from 1990 to 2017 in the globe. (A) The change trends of ASIR and SDI from 1990 to 2017. (B) The change trends of ASDR and SDI from 1990 to 2017. (C) The change trends of age-standardized DALY rate and SDI from 1990 to 2017. ASIR: age-standardized incidence rate; ASDR: age-standardized death rate; EAPC: estimated annual percentage change; DALY: disability-adjusted life year; SDI: Socio-demographic Index.

Figure 5

The incidence rate, death rate, and DALY rate of ALL in different age groups. (A) The incidence rate in 1990. (B) The death rate in 1990. (C) DALY rate in 1990. (D) The incidence rate in 2017. (E) The death rate in 2017. (F) DALY rate in 2017. EAPC: estimated annual percentage change; DALY: disability-adjusted life year; SDI: Socio-demographic Index.

Figure 6

Risk factors contributing to ALL-caused death and DALY. Risk factors contributing to ALL-caused death in the globe (A), high SDI region (B), high-middle SDI region (C), middle SDI region (D), low-middle SDI region (E), and low SDI region (F). Risk factors contributing to ALL-caused DALY in the globe (G), high SDI region (H), high-middle SDI region (I), middle SDI region (J), low-middle SDI region (K), and low SDI region (L). DALY: disability-adjusted life year; SDI: Socio-demographic Index.