Jani Chinmay T, Ahmed Alaaeldin, Singh Harpreet, Mouchati Christian, Al Omari Omar, Bhatt Padmanabh S, Sharma Rajesh, Farooq Minaam, Liu Weitao, Shalhoub Joseph, Marshall Dominic, Salciccioli Justin D, Warner Jeremy L, Lam Prudence
Sylvester Comprehensive Cancer Center at University of Miami, Miami, FL.
Department of Medicine, Mount Auburn Hospital, Harvard Medical School, Cambridge, MA.
JCO Glob Oncol. 2023 Sep;9:e2300229. doi: 10.1200/GO.23.00229.
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.
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.
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.
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.
急性髓系白血病（AML）占成人急性白血病的80%。在过去20年中，年轻患者的治疗取得了进展，但老年患者直到最近改善有限。本研究调查了1990年至2019年全球及欧盟15国以上地区AML的发病趋势。
我们从全球疾病负担研究数据库中提取了按性别分层的年龄标准化发病率（ASIR）、年龄标准化死亡率（ASMR）和伤残调整生命年，并计算了死亡率与发病率之比（MIR）。使用Joinpoint回归比较趋势。
研究结果显示，1990年至2019年全球男女AML发病率均有所上升。在欧盟15国以上地区，大多数国家男女的ASIR均有所上升。Joinpoint分析显示，全球男性患者的ASIR在2010年前稳步上升，2015年前保持稳定，随后至2019年下降。女性患者也观察到类似趋势。对于ASMR，尽管全球和大多数欧盟15国以上地区有所上升，但近年来全球和大多数欧盟15国以上地区的死亡率有统计学显著下降。全球男女的MIR均有所改善。按年龄分层，AML负担在老年组（55岁及以上）中最高，而在20岁以下人群中最低。
我们的研究结果表明，1990年至2019年全球男女AML发病率和死亡率上升，MIR下降，提示生存率提高。然而，Joinpoint分析显示，过去十年女性的MIR没有变化，过去四年男性的MIR也没有变化，表明尽管最近有进展，但生存趋势趋于平稳。
