Global, regional, and national trends in the burden of chronic myeloid leukemia from 1990 to 2021: A comprehensive analysis of the 2021 global burden of disease study and projections to 2050

Abstract Background: Chronic myeloid leukemia (CML) has emerged as a critical public health concern, yet current research on its disease burden and epidemiological trends remains markedly insufficient. This study evaluates the global burden of CML from 1990 to 2021 and projects its trajectory over the next two decades. Methods: Leveraging the latest data from the Global Burden of Disease (GBD) 2021 study, we extracted metrics on incidence, prevalence, mortality, and disability-adjusted life years (DALYs), along with their corresponding age-standardized rates (ASRs). Data were stratified by time, geography, age, and Socio-demographic Index (SDI). Employing advanced statistical methodologies—including estimated annual percentage change (EAPC), health inequality analyses (slope index and concentration index), decomposition analysis, frontier analysis, and ARIMA predictive modeling—this study provides a comprehensive 32-year (1990–2021) assessment of CML trends. Results: In 2021, the global age-standardized incidence rate (ASIR), prevalence rate (ASPR), mortality rate (ASMR), and DALY rate (ASDR) were 0.43 (95% UI: 0.33–0.51), 0.75 (95% UI: 0.61–0.87), 0.28 (95% UI: 0.21–0.34), and 8.30 (95% UI: 5.86–10.59) per 100,000 population, respectively. High-SDI regions exhibited elevated ASIR and ASPR but lower ASMR and ASDR. Males demonstrated higher prevalence, incidence, mortality, and DALY rates across most age groups. Slope index of inequality (SII) analyses for ASIR, ASPR, ASMR, and ASDR suggested potential improvements in health outcome disparities over the past 32 years. Concentration index (CI) analysis confirmed a significant reduction in inequality for ASDR, while ASIR, ASPR, and ASMR showed more modest changes, indicating persistent health disparities in certain regions despite overall progress. Global and SDI-stratified decomposition analyses revealed that population growth and aging contributed to increased disease burden, whereas epidemiological changes mitigated it. Frontier analysis highlighted greater potential for improvement in high-SDI regions. ARIMA modeling projected a marginal rise in ASPR by 2050, with other metrics remaining largely stable. Conclusions: Chronic myeloid leukemia poses a substantial global health and economic challenge. Anticipated demographic shifts, including population growth and aging, are expected to exacerbate its burden, underscoring the urgent need for targeted prevention and control strategies. Health system administrators must develop robust, evidence-based plans to address these escalating health challenges.