Global burden of leukemia in women of child-bearing age, 1990 to 2021: An update from the Global Burden of Disease Study 2021

While the overall burden of leukemia has been studied, a comprehensive and up-to-date epidemiological analysis specifically focused on women of childbearing age (WCBA) using the latest global burden of disease 2021 data, particularly detailing the 4 major subtypes, is lacking. This knowledge gap limits the development of targeted healthcare policies for this unique demographic. This study aims to fill this gap by assessing the global, regional, and national burden of leukemia in WCBA from 1990 to 2021. We collected and analyzed data on acute lymphoblastic leukemia (ALL), acute myeloid leukemia (AML), chronic lymphocytic leukemia, and chronic myeloid leukemia (CML) in WCBA (aged 15-49) from the Global Burden of Disease Study 2021. We evaluated incidence, mortality, and disability-adjusted life years (DALYs), along with their age-standardized rates, categorized by age, region, country, and socio-demographic index. We also analyzed risk factors associated with leukemia-related DALYs and mortality. In 2021, an estimated 40,200 (95% UI 31.3, 45.1) new cases of leukemia among WCBA were reported globally. From 1990 to 2021, the age-standardized incidence rate declined by 22.4% (95% UI-31.2,-11.4), with larger reductions in age-standardized death rate (-34.2%; 95% UI-40.5,-25.7) and DALY rate (-43.1%; 95% UI-50.6,-30.6). The annual disease burden, in descending order, were AML, ALL, CLL, and CML. Epidemiological patterns showed significant regional differences, though CML declined across all regions. The burden of AML, CLL, and CML was positively correlated with age, while ALL peaked in the youngest (15-19) group. Risk factor analysis identified obesity (high-income, middle-aged) and occupational exposures (younger) as significant contributors. While the overall leukemia burden in WCBA has decreased globally, significant disparities persist by subtype, age, and region, with AML remaining the dominant burden. These findings underscore the need for tailored public health strategies and resource allocation to address high-risk populations and specific leukemia subtypes.