Global, regional, and National burden of childhood leukemia from 1990 to 2021

Childhood leukemia is the most common malignant tumor in children and a leading cause of pediatric mortality, imposing substantial economic and health burdens on families. This cross-sectional study analyzed 2021 Global Burden of Disease (GBD) data from 204 countries and regions, focusing on children aged 0 to 14 years diagnosed with leukemia. The study examined trends in childhood leukemia incidence, mortality, and disability-adjusted life years (DALYs) from 1990 to 2021, alongside risk factors for leukemia-related deaths. Trends were stratified by region, country, age, sex, and Sociodemographic Index (SDI). Key metrics included incidence rate, mortality rate, DALYs, and estimated annual percentage change (EAPC). From 1990 to 2021, global incidence, mortality, and DALYs associated with childhood leukemia declined. In 2021, 58,785 new cases were reported worldwide, with an incidence rate of 2.92 per 100,000 population and an EAPC of -0.91%. Boys exhibited higher incidence and mortality rates than girls (incidence:3.31 vs. 2.20; mortality:3.31 vs. 2.50), while children under 1 year old had significantly higher rates than other age groups (incidence: <1 year, boys, 8.05; girls, 6.13; mortality: <1 year, boys, 2.61; girls, 2.14;). Low-SDI regions had the highest number of deaths (7,082 cases), whereas middle-high SDI regions experienced the largest reductions in mortality (EAPC: -4.26). China reported the highest number of cases and deaths (20,321 cases;4,241 cases), while Tokelau had the highest mortality rate and DALYs (7.92 per 100,000;658.54 per 100,000). EAPC was negatively correlated with DALYs (Pearson r = -0.26, P < 0.001). Additionally, the EAPC for DALYs was negatively correlated with SDI (Pearson r = -0.49, P < 0.001), underscoring the impact of SDI levels and baseline disease burden on trends in childhood leukemia. Childhood leukemia remains a pressing global health challenge, with incidence rates continuing to rise in some regions. Despite reductions in global mortality and DALYs, the burden of deaths and DALYs among children with leukemia remains significant, particularly in low-SDI regions. Enhanced understanding of the epidemiology of childhood leukemia may support the development of innovative therapeutic strategies.