Trends in Acute Myeloid Leukemia mortality among patients with diabetes mellitus in the United States, 1999–2024: A CDC wonder database analysis

Abstract Abstract: INTRODUCTION: Diabetes mellitus (DM) is increasingly recognized as a comorbidity that complicates cancer prognosis, including hematological malignancies such as acute myeloid leukemia (AML). However, national trends in AML-related mortality among patients with coexisting DM remain poorly characterized. This study analyzes long-term mortality patterns in this dual-disease population using U.S. national death records. METHODS: Data were sourced from the CDC Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) database for the years 1999–2024. Decedents aged ≥65 years with AML as the underlying cause of death and DM as a contributing cause were included. Age-adjusted mortality rates (AAMRs) were calculated per 1000,000 population. Trends were assessed using Joinpoint regression, yielding annual percent change (APC) estimates. RESULTS: A total of 7,359 deaths were recorded. The AAMR more than doubled, rising from 4.0 in 1999 to 9.6 in 2024, with a significant upward trend throughout the study period (APC: 3.0). Males exhibited a higher AAMR (9.0) compared to females (4.3). Non-Hispanic Whites experienced the greatest burden (6.3) among racial/ethnic groups. Mortality rates were higher in non-metropolitan (7.3) versus metropolitan (5.6) areas. Regionally, the West reported the highest AAMR at 7.5. CONCLUSION: AML-related mortality in older adults with coexisting diabetes has shown a sustained and concerning rise over the past two decades. The findings highlight growing health disparities by sex, geography, and race, emphasizing the urgent need for integrative disease management strategies targeting this vulnerable subgroup. Keywords: Acute Myeloid Leukemia; Diabetes Mellitus; Mortality Trends; CDC WONDER; Comorbidity; Rural Health; Hematologic Malignancies; Health Disparities.