The long-term trends in the disease burden of acute Lymphoblastic Leukemia in China from 1990 to 2021 and projections for the next 15 years

BACKGROUND: This study examines the burden of acute lymphoblastic leukemia (ALL) in China from 1990 to 2021 and predicts future trends over the next 15 years. METHODS: Using data from the 2021 GBD (Global Burden of Disease) study, we applied Joinpoint regression to analyze time trends, the APC (Age-period-cohort) model to assess age, period, and cohort effects, and decomposition analysis to identify key drivers. The ARIMA (Autoregressive integrated moving average model) model was used for forecasting. RESULTS: In 2021, China had 38,571 new cases, 20,613 deaths, and 188,395 people lived with ALL. Incidence declined until 2004, then increased. Prevalence has steadily risen, while mortality and DALYs (disability-adjusted life years) have decreased. The highest burden is seen in children, the elderly, and males. Aging is the main factor behind rising mortality and DALYs. Forecasts show prevalence will keep increasing, while mortality may fall. CONCLUSION: With a growing and aging population, China's ALL burden is expected to rise. Stronger disease management is needed to reduce its impact.