Global Burden and Attributable Risk Factors of Acute Lymphoblastic Leukemia in 204 Countries and Territories from 1990-2019: Estimation Based on Global Burden of Disease Study 2019

Author(s):  
Yuefen Hu ◽  
Xiuping Zhang ◽  
Aijun Zhang ◽  
Yu Hou ◽  
Yang Liu ◽  
...  

Abstract Purpose: To provide a foundational guideline for policy-makers to efficiently allocate medical resources in the context of population aging and growth, a latest spatial distribution and temporal trend of acute lymphoblastic leukemia (ALL) along with attributable risk factors by sex and age were mapped.Methods: Based on the Global Burden of Disease Study 2019, we calculated the estimated annual percentage change (EAPC) values to quantify temporal trends in morbidity and mortality of ALL. We used applied Spearman rank correlation to estimate the relationship between the EAPC and potential influence factors. The population attributable fraction of potential risk factors for ALL-related disability-adjusted life years (DALYs) were estimated by the comparative risk assessment framework. Results: We found that new ALL cases increased significantly by 129% worldwide, and the age-standardized incidence rate (ASIR) increased by 1.61 percent per year. The proportion of elder patients sharply increased, especially within the higher socio-demographic index (SDI) region. Smoking and high body mass index remained the predominant risk factors for ALL-related mortality. Notably, the contribution of high body mass index presented an increasing trend. Conclusion: The global burden of ALL has steadily increased, especially in middle SDI region. Health measures should be taken into consideration to improve the treatment of elders with ALL due to a great proportion in the higher SDI region. Attention should be paid to the environmental problems caused by industrial development in low SDI areas.

PLoS Medicine ◽  
2020 ◽  
Vol 17 (7) ◽  
pp. e1003198 ◽  
Author(s):  
Haijiang Dai ◽  
Tariq A. Alsalhe ◽  
Nasr Chalghaf ◽  
Matteo Riccò ◽  
Nicola Luigi Bragazzi ◽  
...  

2007 ◽  
Vol 25 (12) ◽  
pp. 1498-1504 ◽  
Author(s):  
Riitta A. Niinimäki ◽  
Arja H. Harila-Saari ◽  
Airi E. Jartti ◽  
Raija M. Seuri ◽  
Pekka V. Riikonen ◽  
...  

Purpose The aim of the study was to determine the incidence of and clinical risk factors for radiographic osteonecrosis (ON) in children treated for acute lymphoblastic leukemia (ALL) using the Nordic ALL protocols. Patients and Methods Ninety-seven consecutive patients with childhood ALL were studied prospectively by magnetic resonance imaging (MRI) of the lower extremities at the end of the treatment. Results Twenty-three (24%) of the 97 patients had ON. Seven of the patients (30%) were symptomatic, and three patients (13%) required surgical interventions. Multiple logistic regression analysis showed that high body mass index (BMI; P = .04), female sex (P = .01), older age at diagnosis (P < .001), and higher cumulative dexamethasone dose (P = .03) were independent risk factors for radiographic ON. The cumulative prednisone dose did not differ significantly between the patients with and without ON. The incidence of radiographic ON decreased significantly, from 36% to 7%, when the duration of dexamethasone exposure during the delayed-intensification phase was shortened from 3 to 4 weeks to 2 weeks with a taper (P = .001). Conclusion ON as determined by MRI was found to be a common complication in children and adolescents after treatment with the Nordic ALL protocols. Revision of the ALL protocols by shortening the single exposure to dexamethasone has diminished the risk for ON remarkably. High BMI was identified as a new significant risk factor for ON.


BMJ ◽  
2020 ◽  
pp. m234 ◽  
Author(s):  
Xiaochen Li ◽  
Xiaopei Cao ◽  
Mingzhou Guo ◽  
Min Xie ◽  
Xiansheng Liu

AbstractObjectiveTo describe the temporal and spatial trends of mortality and disability adjusted life years (DALYs) due to chronic respiratory diseases, by age and sex, across the world during 1990-2017 using data from the Global Burden of Disease Study 2017.DesignSystematic analysis.Data sourceThe Global Burden of Diseases, Injuries, and Risk Factors Study 2017.MethodsMortality and DALYs from chronic respiratory diseases were estimated from the Global Burden of Disease Study 2017 using DisMod-MR 2.1, a Bayesian meta-regression tool. The estimated annual percentage change of the age standardised mortality rate was calculated using a generalised linear model with a Gaussian distribution. Mortality and DALYs were stratified according to the Socio-demographic index. The strength and direction of the association between the Socio-demographic index and mortality rate were measured using the Spearman rank order correlation. Risk factors for chronic respiratory diseases were analysed from exposure data.ResultsBetween 1990 and 2017, the total number of deaths due to chronic respiratorydiseases increased by 18.0%, from 3.32 (95% uncertainty interval 3.01 to 3.43) million in 1990 to 3.91 (3.79 to 4.04) million in 2017. The age standardised mortality rate of chronic respiratory diseases decreased by an average of 2.41% (2.28% to 2.55%) annually. During the 27 years, the annual decline in mortality rates of chronic obstructive pulmonary disease (COPD; 2.36%, uncertainty interval 2.21% to 2.50%) and pneumoconiosis (2.56%, 2.44% to 2.68%) has been slow, whereas the mortality rate for interstitial lung disease and pulmonary sarcoidosis (0.97%, 0.92% to 1.03%) has increased. Reductions in DALYs for asthma and pneumoconiosis have been seen, but DALYs due to COPD, and interstitial lung disease and pulmonary sarcoidosis have increased. Mortality and the annual change in mortality rate due to chronic respiratory diseases varied considerably across 195 countries. Assessment of the factors responsible for regional variations in mortality and DALYs and the unequal distribution of improvements during the 27 years showed negative correlations between the Socio-demographic index and the mortality rates of COPD, pneumoconiosis, and asthma. Regions with a low Socio-demographic index had the highest mortality and DALYs. Smoking remained the major risk factor for mortality due to COPD and asthma. Pollution from particulate matter was the major contributor to deaths from COPD in regions with a low Socio-demographic index. Since 2013, a high body mass index has become the principal risk factor for asthma.ConclusionsRegions with a low Socio-demographic index had the greatest burden of disease. The estimated contribution of risk factors (such as smoking, environmental pollution, and a high body mass index) to mortality and DALYs supports the need for urgent efforts to reduce exposure to them.


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