Trends and Attributable Risk Factors of the Global Burden of Lymphoid Malignancies over the Past Fifteen Years
Authors: Tong Hongyan , Lang Wei , Wang Wei , Luo Yingwan , Yang Wenli , Ye Li , Yang Wenbin , Huang Hua , Zhen Xinghua 
Published: December 2024

BackGround:

Lymphoid malignancies pose a significant health challenge globally, with their incidence steadily increasing over the years. Understanding the trends, patterns, and factors influencing these malignancies is crucial for effective prevention and management strategies. In this study, we analyze the incidence rates, demographic distributions, regional variations, and associated risk factors of lymphoid neoplasms to provide a comprehensive overview of the current landscape for the period 2008-2021 from the Global Burden of Disease study.

Methods:

This study uses newest data from the 2021 Global Burden of Disease study spanning 2008 to 2021. It examines the incidence rates and age-standardized rates of various lymphoid malignancies, including Non-Hodgkin lymphoma (Non-HL), Multiple Myeloma (MM), Chronic lymphocytic leukemia (CLL), Acute lymphocytic leukemia (ALL), and Hodgkin lymphoma (HL). Trends in incidence and mortality are analyzed using estimated annual percentage change (EAPC) values. Demographic patterns related to age and gender, regional differences in rates, and the impact of risk factors like body-mass index, occupational exposures, and smoking on outcomes are also assessed.

Results:

Globally, the incidence of lymphoid malignancies has been steadily increasing, reaching 1644.7 thousand cases in 2021. The age-standardized incidence rates (ASIR) for Non-HL, MM, CLL, ALL and HL are 7.14, 1.74, 1.39, 1.37, and 0.79 per 100,000, respectively. While the ASIR for Non-HL, MM and HL remains relatively stable, a declining trend is noted for CLL and ALL. Concurrently, there has been a decline in the age-standardized death rate (ASDR) for other lymphoid malignancies, while an upward trend is noticeable for MM.

Factors influencing the burden of lymphoid malignancies vary by gender, age, region, and socio-demographic indices (SDI). Males consistently exhibit higher ASIR rates for both incidence and mortality. Elderly individuals, aged 60 and above, shoulder a significant burden of certain lymphoid neoplasms, constituting a considerable percentage of cases, notably in MM (78%), Non-Hodgkin lymphoma (61.5%), and Chronic Lymphocytic Leukemia (76.9%). The peak incidence rates of MM, Non-HL and CLL are observed in 70-74 age groups. Conversely, ALL predominantly affects younger patients, with 45% of cases occurring in individuals under 14 years old, although there are two peaks in 0-5 and 90-94 ages for the ASIR of ALL. HL shows a more even distribution across age groups.

Recently, regions such as Andean Latin America, Eastern Europe, East Asia, and Central Sub-Saharan Africa have experienced significant increases in ASIR, while High-income North America, Southern Latin America, and Australasia have seen notable declines in ASDR.

The incidence of lymphoid malignancies is strongly correlated with the prevalence of immune diseases in a given region. High body-mass index stands out as a risk factor for lymphoid neoplasms, particularly in high SDI regions. Occupational exposure to carcinogens and smoking are also significant risk factors for mortality in ALL and CLL, with Middle SDI and Low-Middle SDI regions showing higher proportions of exposure to occupational carcinogens.

Conclusion:

This study's findings will contribute to analyzing trends in the global burden of specific hematologic malignancies and implementing targeted interventions to address these modifiable risks effectively.