Abstract
BackgroundThe prognosis of chronic lymphocytic leukemia (CLL) has been improved dramatically, but there are limited studies focusing on CLL disease burden on a global scale. We aimed to evaluate the accurate assessment of the disease burden of CLL that may provide more detailed epidemiological information for rational policies.MethodsThe main source of the data was the Global Burden of Disease (GBD) study 2019. Incident cases, death cases, disability-adjusted life years (DALYs), and their corresponding age-standardized rates (ASRs) from 1990 to 2019 were used to describe the burden of CLL. Data about attributable risk factors were also extracted and analyzed. Bayesian age-period-cohort (BAPC) models were used to assess and project the incidence and mortality rates till 2030.ResultsGlobally, the incidence of CLL had been increasing. Deaths and DALYs decreased slightly. The burden of death and DALY is affected by socio-demographic index (SDI). The incidence rate, death rate, and DALY rate of CLL increased significantly with age. Male-to-female ratios of incidence rates varied in different SDI quintiles. Smoking, high body mass index, and occupational exposure to benzene or formaldehyde were the potential risk factors related to CLL. Global ASIRs might tend to increase until 2030, while ASDR would decrease until 2030.ConclusionThe disease burden of CLL decreased in higher SDI countries but increased in lower ones. Strategies for early detection of asymptomatic CLL, development of novel drugs, and measures against attributable factors should be implemented to combat CLL burden.
Highlights
Chronic lymphocytic leukemia (CLL) is a mature B-cell neoplasm characterized by the progressive accumulation of monoclonal B lymphocytes
The global incident number of chronic lymphocytic leukemia was 1,034.67 ×102 [95% uncertainty interval (UI) = (934.64, 1,189.42)] in 2019, with a total increase of 155.24% from 1990 (Figures 1A–C, Table 1 and Supplementary Table S1)
The global agestandardized incidence rate (ASIR) was 1.28 (1.16, 1.48) per 100,000, and it showed an increasing trend with an annual average of 0.47% [estimated annual percentage changes (EAPCs) = 0.47; 95% CI = (0.33, 0.61)] from 1990 to 2019 (Figures 2A–C, Figure 3 upper, Table 1 and Supplementary Table S4)
Summary
Chronic lymphocytic leukemia (CLL) is a mature B-cell neoplasm characterized by the progressive accumulation of monoclonal B lymphocytes. It is the most prevalent type of leukemia in the Western hemisphere, accounting for approximately 25% to 35% of all leukemias in the United States [1]. Five-year overall survival has been more than 60% in the era of BTKi [8–10], and is about 86% after the advent of venetoclax [11] Access to these novel agents is still limited to certain developed countries, so every effort should be made to ensure patients of developing countries could benefit from these outstanding medicines [12]. We aimed to evaluate the accurate assessment of the disease burden of CLL that may provide more detailed epidemiological information for rational policies
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