Demographics and trends of acute myeloid leukemia among young adults in the United States and Puerto Rico, 1999-2021.

Abstract

e18502 Background: We assessed racial and sex-related trends in deaths from Acute Myeloid Leukemia (AML) among US and Puerto Rico young adults (15–49 years) from 1999–2021. Methods: Cross-sectional analysis of CDC WONDER mortality data was performed. AML deaths were extracted, and age-adjusted mortality rates (AAMR) per 100,000 with annual percent changes (APC) were calculated using Joinpoint regression. Analyses were stratified by sex and race/ethnicity. Results: There were 20,295 AML deaths among young adults. Overall AAMR declined from 0.65/100,000 in 1999 to 0.47/100,000 in 2021 (28% reduction). Joinpoint analysis showed no change from 1999–2008 (APC –0.21%, p=0.65) but significant decline 2008–2021 (APC –2.38%, p<0.0001). By sex, males and females had similar 1999 AAMRs (0.65 vs. 0.66); by 2021 both were 0.47. Males showed a significant decrease 2008–2021 (APC –2.62%, p<0.0001), females declined steadily across the study period (APC –1.52%, p<0.0001). By race, Whites declined from 0.67 to 0.49 (APC –2.51%, p=0.0004, 2008–2021), Blacks from 0.67 to 0.48 (APC –1.31%, p=0.0008), and Asian/Pacific Islanders from 0.67 to 0.36 with significant decrease 2016–2021 (APC –9.82%, p=0.002). American Indian/Alaska Native rates were suppressed due to small counts. Conclusions: AML mortality among US/PR young adults significantly declined over two decades, likely due to improved chemotherapy, supportive care, risk-adapted therapy, and advances in bone marrow transplantation.