Trends in disease burden of chronic myeloid leukemia at the global, regional, and national levels: a population-based ep
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Experimental Hematology & Oncology Open Access
RESEARCH
Trends in disease burden of chronic myeloid leukemia at the global, regional, and national levels: a population‑based epidemiologic study Liqing Ning1†, Chuanyu Hu2†, Pingfan Lu1, Yimei Que1, Xiaojian Zhu1* and Dengju Li1*
Abstract Background: Outcomes of chronic myeloid leukemia (CML) has been improved dramatically in the past two decades, but survival levels of CML patients varied in regions. Comprehensive epidemiological research is necessary to evaluate the global burden of CML. Methods: All data used in our study came from the Global Burden of Disease (GBD) study 2017. Incidence cases, death cases, disability-adjusted life-years (DALYs), and its corresponding age-standardized rate between 1990 to 2017 were used to describe the distribution of CML burden, according to age, sex, social-demographic index (SDI), and countries. Data about attributable risk factors contributing to CML deaths and DALYs were also extracted and analyzed. Results: Globally, the disease burden of CML gradually decreased from 1990 to 2017. Higher SDI countries achieved a remarkable effect on diminishing the CML burden. Conversely, due to population growth, the incidence cases, death cases, and DALYs of CML in lower SDI quintiles showed an upward trend. India had the most incidence cases and death cases of CML in the world. Additionally, smoking was the most significant attributable risk factor contributing to CML deaths and DALYs, followed by high body mass index. Conclusion: The disease burden of CML decreased globally, especially in higher SDI countries in the past 28 years. The increasing incidence cases and death cases were mainly observed in lower SDI countries. Additionally, strategies to control modifiable risk factors such as smoking and high body mass index might be useful in diminishing mortality and DALYs. Keywords: Chronic myeloid leukemia, Global burden, Cancer epidemiology, Incidence, Deaths Background Chronic myeloid leukemia (CML) is a clonal hematopoietic stem cell disorder with characteristic Philadelphia chromosome, which leads to an excessive burden of myeloid cells in patients [1]. CML is an age-related neoplasm that commonly happened in older people. The median *Correspondence: [email protected]; [email protected] † Liqing Ning and Chuanyu Hu equally contributed to this work 1 Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China Full list of author information is available at the end of the article
age at diagnosis was estimated to be 60 years in western countries, but the age at diagnosis in Africa and Asia was about ten years younger [2, 3]. CML is the first cancer with specific genotype knowledge, which led to a rationally therapeutic schedule [4]. Imatinib, a tyrosine kinase inhibitor (TKI), was approved by the FDA to treat CML in 2001 and revolutionized the treatment pattern of this disease [5, 6]. Indeed, thanks to TKI-based treatment, CML’s status switched from
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