Global epidemiology and burden of multiple myeloma from 1990 to 2021 with projections to 2045 based on the global burden of disease study 2021

Multiple myeloma (MM) is a complex hematological malignancy characterized by the abnormal proliferation of malignant plasma cells in the bone marrow. This study aims to provide a comprehensive assessment of MM’s global epidemiology, disease burden, and attributable risk factors from 1990 to 2021, with projections to 2045. A descriptive epidemiological analysis was conducted using data from the Global Burden of Disease (GBD) 2021 study, encompassing 204 countries and territories. Key metrics such as incidence, prevalence, mortality, years lived with disability(YLDs), years of life lost (YLLs), disability-adjusted life years (DALYs), and age-standardized rates (ASRs) were analyzed. Statistical analyses, including Joinpoint regression and decomposition analysis, were employed to identify trends and driving factors behind disease burden changes. Projections to 2045 were generated using BAPC and Nordpred models. Analyses were stratified by age, sex, region, and socio-demographic index (SDI) levels. Between 1990 and 2021, global MM incidence, prevalence, and mortality increased 2-3-fold, reaching approximately 148,754 new cases, 394,482 prevalent cases, and 116,360 deaths in 2021. High-income regions such as North America and Western Europe showed higher disease burdens, reflecting better diagnostics and aging populations, while low-income regions likely underestimated the true burden due to limited healthcare access. High BMI was identified as the only risk factor, with its attributable burden rising significantly. Decomposition analysis revealed population aging and growth as key contributors to the increasing burden, while epidemiological changes in high SDI regions mitigated mortality and disability rates. Projections to 2045 indicate continued growth in absolute case numbers, though ASRs are expected to decline slightly. The global burden of MM has risen substantially over the past three decades, driven by demographic transitions and increasing risk factors such as obesity. High-income regions have achieved better outcomes through advances in diagnostics and therapies, but low SDI regions remain disproportionately affected. Efforts to address MM’s global impact must focus on equitable access to healthcare, targeted prevention strategies, and continued research to understand disease mechanisms and optimize interventions. Projections emphasize the urgent need for integrated global health policies to mitigate MM’s impact.