Cross State Comparative Assessment of Burden of Myeloproliferative Disorders, Myelodysplastic Syndromes and Other Hematopoietic Neoplasms in the United States from 1990-2021
Authors: Jain Hardik , Dudhat Kushal , Bhavanam Sravani , Syed Saifullah , Vala Janmay , Lakkimsetti Mohit , Amin Vishrant , Dharia Adit Alpesh , Patel Juhi , Desai Hardik Dineshbhai , Patel Dharmik , Modi Shivani , Patel Rajkumar 
Published: December 2024

Myeloproliferative disorders (MPDs), myelodysplastic syndromes (MDS), and other hematopoietic neoplasms represent a diverse group of hematologic diseases characterized by dysregulated blood cell production and variable progression to acute leukemia. In the United States, these disorders collectively impose a significant health burden, compounded by challenges in early diagnosis, treatment complexities, and long-term management. This study leverages a comprehensive dataset spanning from 1990 to 2021 to analyze these changes, providing insights into the burden and trends of these disorders. By examining these parameters across different states, the research aims to uncover regional disparities and temporal patterns. This analysis is crucial for developing targeted healthcare policies and improving resource allocation, ultimately enhancing the management and care of patients with hematologic neoplasms.

Using GBD study 2021, we estimated incidence, prevalence, mortality and disability-adjusted life years (DALYs) due to MPDs, MDS and other hematopoietic neoplasms by age, sex, year and location across the United States from 1990-2021. Non-fatal health outcome were assessed by using DiSMOD MR-2.1 a meta regression tool, while fatal health outcome were assessed using cause of death ensemble model (CODEm).

From 1990 to 2021, the total percentage of change (TPC) in the prevalence of myeloproliferative, myelodysplastic, and other hematopoietic neoplasms in the United States saw a substantial increase of 147% (95% uncertainty interval: 127-172%). During the same period, deaths associated with these conditions rose by 95% (66-125%), and Disability-Adjusted Life Years (DALYs) increased by 82% (56-104%). On the other hand, the age-standardized rates present a different trend; the prevalence rate escalated by 44% (32-59%), whereas the age-standardized mortality rate (ASMR) and age-standardized DALY rate (ASDALR) experienced marginal changes, increasing by 4% (-11 to 20%) and 1% (-13 to 13%), respectively. Regionally, the highest increase in the age-standardized incidence rate (ASIR) was noted in Massachusetts (40%), followed by New York (36%) and Florida (35%). In contrast, West Virginia displayed the smallest increase at 13%. In terms of ASMR, Mississippi witnessed the most significant rise (21%), followed by Tennessee (16%) and Nebraska (15%). The District of Columbia, however, saw a notable decrease in ASMR by 13%. Age-specific analysis revealed that the highest incidence rates occurred in individuals aged 70-74, with 9,086 cases in 2021. The highest death toll was observed in the 80-84 age group, with 1,918 fatalities, and the most DALYs were recorded among those aged 75-79, totaling 30,146 in 2021. Gender differences also emerged in the data, with males exhibiting a generally higher burden across all metrics. The TPC in incidence for males was 129% compared to 108% for females. Similarly, deaths and DALYs in males increased by 107% and 89%, respectively, while the increases for females were slightly lower at 80% and 74%.

The escalating trends in prevalence, mortality, and DALYs associated with MPDs, MDS and other hematopoietic neoplasms over the last three decades underscore a growing healthcare challenge within the United States. These findings highlight a critical need for enhanced screening and early diagnosis programs, particularly in states exhibiting the highest increases. Furthermore, tailored public health interventions and resource allocation are essential to address the significant gender disparities and regional differences observed. Collective efforts in these areas could significantly mitigate the burden of these hematologic disorders, improving outcomes and quality of life for affected populations.