Hematological malignancy burden in mainland China and Taiwan from 1990 to 2021 and decadal projections: Insights from the global burden of disease study 2021

Abstract

Objectives: Hematological malignancies (HMs) pose a severe threat to human health and contribute substantially to the disease burden in mainland China and Taiwan. Therefore, understanding their burden is crucial for informed decision-making and the effective allocation of healthcare resources.

Methods: This study utilized the latest data from the Global Burden of Disease 2021 study to describe the epidemiological indices of HMs in mainland China and Taiwan from 1990 to 2021. The future disease burden was projected for the next decade using the Bayesian age-period cohort (BAPC) model.

Results: Between 1990 and 2021, mainland China experienced an increase in the prevalence and incidence of leukemia and lymphoma, while the mortality and disability-adjusted life years (DALYs) for these diseases declined. Conversely, Taiwan witnessed an overall increase in the prevalence, incidence, mortality, and DALYs of leukemia over the same period. Additionally, multiple myeloma (MM), myelodysplastic/myeloproliferative neoplasms, and other hematopoietic neoplasms have shown significant increases in prevalence, incidence, mortality, and DALYs in China. While the disease burden of myeloid leukemia decreased in mainland China, that of lymphoid neoplasms (including leukemia, lymphoma, and MM) increased, which was not observed in Taiwan. Predictions from the BAPC model suggest that the incidence of several lymphoid neoplasms and MM is expected to increase in mainland China and Taiwan.

Conclusions: Taiwan continues to face greater challenges in managing HMs compared to mainland China. MM imposes a significant burden on the Chinese population. The findings of this study provide valuable epidemiological insights for optimizing the allocation of medical resources.

Fig 1. Age- and sex-specific distribution of prevalence, incidence, mortality, and DALY rates for leukemia in mainland China.

(A) Distributions of age-standardized prevalence rates (ASPR), incidence rates (ASIR), mortality rates (ASMR), and DALY rates (ASDR) for acute lymphoid leukemia (ALL). (B) Distributions of ASPR, ASIR, ASMR, ASDR for acute myeloid leukemia (AML). (C) Distributions of ASPR, ASIR, ASMR, ASDR for chronic lymphoid leukemia (CLL). (D) Distributions of ASPR, ASIR, ASMR, ASDR for chronic myeloid leukemia (CML). (E) Distributions of ASPR, ASIR, ASMR, ASDR for other leukemia.

Fig 2. Age- and sex-specific distribution of prevalence, incidence, mortality, and DALY rates for lymphoma, multiple myeloma, and other hematological neoplasms in mainland China.

(A) Distributions of age-standardized prevalence rates (ASPR), incidence rates (ASIR), mortality rates (ASMR), and DALY rates (ASDR) for Hodgkin lymphoma (HL). (B) Distributions of ASPR, ASIR, ASMR, ASDR for Burkitt lymphoma (BL). (C) Distributions of ASPR, ASIR, ASMR, ASDR for other non-Hodgkin lymphoma (NHL). (D) Distributions of ASPR, ASIR, ASMR, ASDR for multiple myeloma (MM). (E) Distributions of ASPR, ASIR, ASMR, ASDR for myelodysplastic, myeloproliferative (MD/MP), and other hematopoietic neoplasms.

Fig 3. Disease burden trends of leukemia and lymphoma analyzed by joinpoint regression analysis in mainland China.

Overall trends of age-standardized prevalence rates (ASPR), incidence rates (ASIR), mortality rates (ASMR), and DALY rates (ASDR) for leukemia (A) and lymphoma (B) from 1990 to 2021, as indicated.

Fig 4. Disease burden trends of multiple myeloma and other hematological neoplasms analyzed by joinpoint regression analysis in mainland China.

Overall trends of age-standardized prevalence rates (ASPR), incidence rates (ASIR), mortality rates (ASMR), and DALY rates (ASDR) for multiple myeloma (MM) (A) and myelodysplastic, myeloproliferative (MD/MP), and other hematopoietic neoplasms (B) from 1990 to 2021, as indicated.

Fig 5. Projections of incidence for hematological malignancies in mainland China.

Overall trends of age-standardized incidence rates (ASIR) for acute lymphoid leukemia (ALL) (A), acute myeloid leukemia (AML) (B), chronic lymphoid leukemia (CLL) (C), chronic myeloid leukemia (D), other leukemia (E), Hodgkin lymphoma (HL) (F), Burkitt lymphoma (BL) (G), other non-Hodgkin lymphoma (NHL) (H), multiple myeloma (MM) (I), and myelodysplastic, myeloproliferative (MD/MP), and other hematopoietic neoplasms (J) from 1990 to 2032, as indicated.

Fig 6. Projections of mortality for hematological malignancies in mainland China.

Overall trends of age-standardized mortality rates (ASMR) for acute lymphoid leukemia (ALL) (A), acute myeloid leukemia (AML) (B), chronic lymphoid leukemia (CLL) (C), chronic myeloid leukemia (D), other leukemia (E), Hodgkin lymphoma (HL) (F), Burkitt lymphoma (BL) (G), other non-Hodgkin lymphoma (NHL) (H), multiple myeloma (MM) (I), and myelodysplastic, myeloproliferative (MD/MP), and other hematopoietic neoplasms (J) from 1990 to 2032, as indicated.