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      Leukemia incidence trends at the global, regional, and national level between 1990 and 2017

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          Abstract

          Background

          Leukemias are a group of life-threatening malignant disorders of the blood and bone marrow. The incidence of leukemia varies by pathological types and among different populations.

          Methods

          We retrieved the incidence data for leukemia by sex, age, location, calendar year, and type from the Global Burden of Disease online database. The estimated average percentage change (EAPC) was used to quantify the trends of the age-standardized incidence rate (ASIR) of leukemia from 1990 to 2017.

          Results

          Globally, while the number of newly diagnosed leukemia cases increased from 354.5 thousand in 1990 to 518.5 thousand in 2017, the ASIR decreased by 0.43% per year. The number of acute lymphoblastic leukemia (ALL) cases worldwide increased from 49.1 thousand in 1990 to 64.2 thousand in 2017, whereas the ASIR experienced a decrease (EAPC = − 0.08, 95% CI − 0.15, − 0.02). Between 1990 and 2017, there were 55, 29, and 111 countries or territories that experienced a significant increase, remained stable, and experienced a significant decrease in ASIR of ALL, respectively. The case of chronic lymphocytic leukemia (CLL) has increased more than twice between 1990 and 2017. The ASIR of CLL increased by 0.46% per year from 1990 to 2017. More than 85% of all countries saw an increase in ASIR of CLL. In 1990, acute myeloid leukemia (AML) accounted for 18.0% of the total leukemia cases worldwide. This proportion increased to 23.1% in 2017. The ASIR of AML increased from 1.35/100,000 to 1.54/100,000, with an EAPC of 0.56 (95% CI 0.49, 0.62). A total of 127 countries or territories experienced a significant increase in the ASIR of AML. The number of chronic myeloid leukemia (CML) cases increased from 31.8 thousand in 1990 to 34.2 thousand in 2017. The ASIR of CML decreased from 0.75/100,000 to 0.43/100,000. A total of 141 countries or territories saw a decrease in ASIR of CML.

          Conclusions

          A significant decrease in leukemia incidence was observed between 1990 and 2017. However, in the same period, the incidence rates of AML and CLL significantly increased in most countries, suggesting that both types of leukemia might become a major global public health concern.

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          Most cited references25

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          Acute lymphoblastic leukaemia.

          Acute lymphoblastic leukaemia occurs in both children and adults but its incidence peaks between 2 and 5 years of age. Causation is multifactorial and exogenous or endogenous exposures, genetic susceptibility, and chance have roles. Survival in paediatric acute lymphoblastic leukaemia has improved to roughly 90% in trials with risk stratification by biological features of leukaemic cells and response to treatment, treatment modification based on patients' pharmacodynamics and pharmacogenomics, and improved supportive care. However, innovative approaches are needed to further improve survival while reducing adverse effects. Prognosis remains poor in infants and adults. Genome-wide profiling of germline and leukaemic cell DNA has identified novel submicroscopic structural genetic changes and sequence mutations that contribute to leukaemogenesis, define new disease subtypes, affect responsiveness to treatment, and might provide novel prognostic markers and therapeutic targets for personalised medicine. Copyright © 2013 Elsevier Ltd. All rights reserved.
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            Acute myeloid leukaemia

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              Infection, immune responses and the aetiology of childhood leukaemia.

              Childhood leukaemia is the principal subtype of paediatric cancer and, despite success in treatment, its causes remain enigmatic. A plethora of candidate environmental exposures have been proposed, but most lack a biological rationale or consistent epidemiological evidence. Although there might not be a single or exclusive cause, an abnormal immune response to common infection(s) has emerged as a plausible aetiological mechanism.
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                Author and article information

                Contributors
                liyong7229771@163.com
                qwang5545@sina.com
                Journal
                Exp Hematol Oncol
                Exp Hematol Oncol
                Experimental Hematology & Oncology
                BioMed Central (London )
                2162-3619
                19 June 2020
                19 June 2020
                2020
                : 9
                : 14
                Affiliations
                [1 ]Department of Hematology, Maoming People’s Hospital, Maoming, Guangdong 525000 China
                [2 ]GRID grid.263488.3, ISNI 0000 0001 0472 9649, Health Science Center, Shenzhen Second People’s Hospital, , The First Affiliated Hospital of Shenzhen University, ; Shenzhen, 518020 China
                [3 ]Digestion Department of Digestion, Maoming People’s Hospital, Maoming, Guangdong 525000 China
                [4 ]GRID grid.452842.d, Department of Obstetrics and Gynecology, , The Second Affiliated Hospital of Zhengzhou University, ; Zhengzhou, Henan 450014 China
                [5 ]GRID grid.207374.5, ISNI 0000 0001 2189 3846, School of Public Health, , Zhengzhou University, ; Zhengzhou, Henan 450014 China
                [6 ]GRID grid.459540.9, ISNI 0000 0004 1791 4503, Department of Oncology, , Guizhou Provincial People’s Hospital, ; Guiyang, Guizhou 550002 China
                [7 ]China-Canada Medical and Healthcare Science Association, Toronto, ON L3R 1A3 Canada
                Article
                170
                10.1186/s40164-020-00170-6
                7304189
                31908904
                ff91b707-998a-43ef-81c9-a737df965f63
                © The Author(s) 2020

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 30 April 2020
                : 15 June 2020
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100001809, National Natural Science Foundation of China;
                Award ID: 81960587
                Award Recipient :
                Funded by: FundRef http://dx.doi.org/10.13039/501100004001, Guizhou Science and Technology Department;
                Award ID: LH [2015]7171
                Funded by: FundRef http://dx.doi.org/10.13039/501100010828, Department of Education of Guizhou Province;
                Award ID: 2019-89
                Award Recipient :
                Funded by: High-level Hospital Construction Research Project of Maoming People’s Hospital
                Categories
                Research
                Custom metadata
                © The Author(s) 2020

                Oncology & Radiotherapy
                leukemia,all,cll,aml,cml,incidence,global
                Oncology & Radiotherapy
                leukemia, all, cll, aml, cml, incidence, global

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