Burden of AML, 1990-2019: Estimates From the Global Burden of Disease Study

Abstract

Purpose: AML accounts for 80% of acute leukemia in adults. While progress has been made in treating younger patients in the past 2 decades, there has been limited improvement for older patients until recently. This study examines the global and European Union (EU) 15+ trends in AML between 1990 and 2019.

Methods: We extracted age-standardized incidence rates (ASIRs), age-standardized death rates (ASMRs), and disability-adjusted life years, stratified by sex from the Global Burden of Disease Study database, and mortality-to-incidence ratio (MIR) were computed. Trends were compared using Joinpoint regression.

Results: The findings show a global increase in AML incidence for both sexes from 1990 to 2019. In the EU15+ countries, most countries exhibited an increase in ASIR for both sexes. Joinpoint revealed that globally for male patients, ASIR steadily increased until 2010, remained stable until 2015 followed by a decline till 2019. Similar trends were observed in female patients. For ASMR, although there was an increase globally and in most EU15+ countries, there was a statistically significant decrease in mortality rates globally and in the majority of EU15+ countries in recent years. MIR improved in both sexes globally. On age stratification, AML burden was highest among older groups (55 years and older), while the lowest rates were observed in younger than 20 years.

Conclusion: The findings from our study indicate a global rise in AML incidence and mortality in both sexes and decrease in MIR from 1990 to 2019 suggesting a better survival. However, on Joinpoint analysis, there is no change in MIR in women in the past decade and past 4 years in men indicating plateau in survival trends despite recent advances.

FIG 1

Trends in ASIRs per 100,000 for AML Globally, in WHO regions and European Union 15+ countries between 1990 and 2019. Open squares indicate male patients, and filled circles indicate female patients. ASIR, age-standardized incidence rate.

FIG 2

Trends in ASMRs per 100,000 for AML Globally, in WHO regions and European Union 15+ countries between 1990 and 2019. Open squares indicate male patients, and filled circles indicate female patients. ASMR, age-standardized mortality rate.

FIG 3

Trends in DALYs per 100,000 for AML Globally, in WHO regions and European Union 15+ countries between 1990 and 2019. Open squares indicate male patients, and filled circles indicate female patients. DALY, disability-adjusted life year.