Abstract
BackgroundAcute myeloid leukemia (AML) is a common leukemia subtype and has a poor prognosis. The risk of AML is highly related to age. In the context of population aging, a comprehensive report presenting epidemiological trends of AML is evaluable for policy-marker to allocate healthy resources.MethodsThis study was based on the Global Burden of Disease 2017 database. We analyzed the change trends of incidence rate, death rate, and disability-adjusted life year (DALY) rate by calculating the corresponding estimated annual percentage change (EAPC) values. Besides, we investigated the influence of social development degree on AML’s epidemiological trends and potential risk factors for AML-related mortality.ResultsFrom 1990 to 2017, the incidence of AML gradually increased in the globe. Males and elder people had a higher possibility to develop AML. Developed countries tended to have higher age-standardized incidence rate and death rate than developing regions. Smoking, high body mass index, occupational exposure to benzene, and formaldehyde were the main risk factors for AML-related mortality. Notably, the contribution ratio of exposure to carcinogens was significantly increased in the low social-demographic index (SDI) region than in the high SDI region.ConclusionGenerally, the burden of AML became heavier during the past 28 years which might need more health resources to resolve this population aging-associated problem. In the present stage, developed countries with high SDI had the most AML incidences and deaths. At the same time, developing countries with middle- or low-middle SDI also need to take actions to relieve rapidly increased AML burden.
Highlights
Acute myeloid leukemia (AML) is a common leukemia subtype and has a poor prognosis
The results showed that all Age-standardized rate (ASR) values were markedly positively correlated with social-demographic index (SDI) (Fig. 5a–c)
We found that the estimated annual percentage change (EAPC) of Age-standardized incidence rate (ASIR) was negatively correlated with ASIR in 1990 which indicated that the incidence might be underestimated in regions with a low incidence rate (Fig. 4a)
Summary
Acute myeloid leukemia (AML) is a common leukemia subtype and has a poor prognosis. The risk of AML is highly related to age. The alterations of genes such as FLT3, IDH1, IDH2, TET2, ASXL1, and DNMT3A could be found in the bone marrow or peripheral blood of patients without overt AML [6,7,8,9,10,11,12] This status is termed clonal hematopoiesis of indeterminate potential (Chip) [13]. For patients harboring Chip, the risk of having AML is increased after cytotoxic treatment [5] Some somatic mutations such as TP53 mutation endow preleukemic hemopoietic stem cells with enhanced resistance to chemotherapy which further elevates the competitive advantage over normal hemopoietic stem cells [16, 17]
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