Global burden of multiple myeloma: Analysis from 1980 to 2021.
Authors: Anthony Yeung, Silpa Choday, Ragul Yuvaraj, Varun Vankeshwaram, Miguel Gonzalez-Velez
Journal: Journal of Clinical Oncology (2025)

e19535 Background: Multiple myeloma (MM) represents approximately 10% of all hematologic malignancies. The diagnosis is established with the presence of ≥10% clonal bone marrow plasma cells or a biopsy-confirmed plasmacytoma, along with evidence of at least one defining event for multiple myeloma. These defining events, known as the CRAB criteria, include hypercalcemia, renal failure, anemia, and lytic bone lesions. With an aging population, improved testing, and new treatments, our study aims to analyze the global trends and differences in mortality patterns of MM. Methods: Data was retrieved from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021, depicting the MM mortality pattern from 1980 to 2021. The study includes age-standardized death rates (ASDR), incidence, Years of Life Lost (YLL), Years Lived with Disability (YLDs) and Disability-Adjusted Life Years (DALYs). The dataset was stratified globally and categorized by the United States and by the World Bank income levels. Results: Between 1980 and 2021, the global ASDR for MM showed an increase. In 1980, the ASDR was 1.18 (95% UI: 1.08–1.27), rising to 1.37 (95% CI: 1.22–1.52) by 2021. The global DALYs rate also increased, from 28.34 (95% UI: 26.33–30.83) per 100,000 people in 1990 to 30.0 (95% CI: 26.22–33.37) in 2021. Similarly, the incidence rate rose from 1.47 (95% CI: 1.37–1.57) to 1.74 (95% CI: 1.54–1.89) during this period. The age-standardized YLDs increased from 0.71 (95% CI: 0.51–0.90) in 1990 to 0.97 (95% CI: 0.70–1.26) in 2021, while the YLL rose from 25.85 (95% CI: 23.74–28.19) to 29.04 (95% CI: 25.32–32.36). In contrast, the United States experienced declines in several key metrics between 1990 and 2021. The death rate decreased from 3.27 (95% CI: 3.07–3.38) to 2.84 (95% CI: 2.58–2.99), DALYs dropped from 73.82 (95% CI: 71.01–75.64) to 57.79 (95% CI: 54.27–60.26), and YLL declined from 72.60 (95% CI: 69.82–74.30) to 56.57 (95% CI: 53.09–58.92). The incidence rate also declined from 3.22 (95% CI: 3.05–3.32) to 2.95 (95% CI: 2.70–3.09). By income classification, death rates in low-income and middle-income countries increased between 1980 and 2021, while high-income countries maintained a steady death rate over the same period. Conclusions: This study shows significant disparities between MM mortality patterns when comparing the United States to the world across income levels. Although the ASDR, incidence, YLL, YLDs, and DALYs are lower worldwide compared to the United States, these global rates are higher in 2021 compared to 1980. Meanwhile, the USA has experienced notable decreases in death rate, DALYs, YLL, and incidence of MM during this same period. While these reflect significant advances in diagnostic testing and treatment modalities in the USA over a forty year span, the rest of the world has not shown a similar progression. A growing health burden and significant disparities remain, indicating a lack of resources in low and middle income countries around the world.