Global leukemia incidence and EAPC, 1990-2021.

Background: Leukemia is a prevalent form of cancer that encompasses four primary subtypes, posing significant health risks. Gaining insights into the global epidemiology of leukemia and its subtypes is crucial for effective resource allocation, clinical guidance, and scientific inquiry. Methods: From 1990 to 2021, we analyzed age-standardized rates (ASR) trends across 204 countries and territories, utilizing the estimated annual percentage change (EAPC). Results: In 2021, there were approximately 460,000 leukemia cases, 320,000 deaths, and 10.98 million disability-adjusted life years (DALYs). Globally, age-standardized incidence rates (ASIR), mortality rates (ASMR), and DALY rates are on the decline, while age-standardized prevalence rates (ASPR) are rising in high social demographic index (SDI) regions. Men experience a higher leukemia burden compared to women. By subtype, acute myeloid leukemia (AML), chronic myeloid leukemia (CML), and chronic lymphocytic leukemia (CLL) predominantly impact older individuals, while acute lymphoblastic leukemia (ALL) primarily affects children. Notably, leukemia ASIR and ASDR reductions are observed in countries with high human development index (HDI). Conclusion: Although there has been a marked decrease in global leukemia incidence, mortality, and DALYs over the past 31 years, the rise in new cases due to population growth suggests an increasing overall disease burden by 2050. Furthermore, the impact of leukemia varies significantly by region and country, highlighting the urgent need for innovative and personalized prevention and treatment approaches to mitigate this global health issue.研究背景：白血病是一类高发癌症，涵盖四种主要亚型，对人类健康构成严重威胁。深入阐明白血病及其亚型的全球流行病学特征，对于优化医疗资源配置、指导临床实践以及推进相关科学研究均具有关键意义。 研究方法：本研究针对1990年至2021年间全球204个国家及地区的数据展开分析，以年龄标化率（age-standardized rates, ASR）为核心观测指标，采用估计年度百分比变化（estimated annual percentage change, EAPC）量化分析其变化趋势。 研究结果：2021年全球白血病新增病例约46万例、死亡病例约32万例，伤残调整寿命年（disability-adjusted life years, DALYs）总计达1098万。全球范围内，年龄标化发病率（age-standardized incidence rates, ASIR）、年龄标化死亡率（age-standardized mortality rates, ASMR）及DALY率均呈下降趋势；而高社会人口指数（social demographic index, SDI）地区的年龄标化患病率（age-standardized prevalence rates, ASPR）则呈上升态势。男性所承受的白血病疾病负担显著高于女性。按亚型分类来看，急性髓系白血病（acute myeloid leukemia, AML）、慢性髓系白血病（chronic myeloid leukemia, CML）与慢性淋巴细胞白血病（chronic lymphocytic leukemia, CLL）主要累及老年人群，而急性淋巴细胞白血病（acute lymphoblastic leukemia, ALL）则以儿童群体为主要发病人群。值得关注的是，人类发展指数（human development index, HDI）较高的国家，其白血病的ASIR与ASDR均出现显著下降。 研究结论：尽管过去31年间全球白血病的发病率、死亡率及DALY总数均出现明显下降，但受人口增长影响，新增病例数持续攀升，预示到2050年整体疾病负担或将进一步加重。此外，白血病的疾病影响存在显著的地区与国家异质性，这凸显了亟需开发创新型、个性化的防控与治疗方案，以有效应对这一全球性公共卫生难题。