Temporal trends in myeloproliferative neoplasms–related mortality in the United States over the last three decades: An analysis of the Global Burden of Disease database.

Abstract

e18601 Background: Myeloproliferative neoplasms (MPNs) are a group of hematologic malignancies associated with substantial morbidity and mortality. Understanding long-term mortality trends is crucial for guiding healthcare strategies and assessing the impact of advancements in diagnosis and treatment. Methods: Mortality data, including age-standardized morality rate, for MPNs in the United States from 1990 to 2019 were obtained from the Global Burden of Disease database. Temporal trends were analyzed using Joinpoint regression analysis by calculating the Annual Percentage Change (APC) and Average Annual Percentage Change (AAPC). Results: Total Mortality: An estimated total of 222,511 MPN-related deaths were reported from 1990 to 2019. Overall Trends: MPN-related mortality exhibited an overall increasing trend (AAPC: 0.102, 95% CI: 0.067 to 0.133; p < 0.001). Mortality initially rose during 1990 to 2001 (APC: 0.67; p = 0.0004), followed by a decline from 2001 to 2004 (APC: -1.02; p = 0.037), and a subsequent increase from 2004 to 2011 (APC: 0.80; p = 0.037). A stabilization phase occurred from 2011 to 2015 (APC: -0.45; p > 0.05), followed by a significant decline from 2015 to 2019 (APC: -1.44%; p < 0.001). Gender-Specific Trends: Females: Mortality rates initially increased (APC: 0.85 from 1990 to 2001; p < 0.001), followed by declines from 2001 to 2004 (APC: -1.17%; p < 0.001) and fluctuations in subsequent years, with a final significant decline from 2016 to 2019 (APC: -1.91; p < 0.001). The overall AAPC for females was 0.053%, which was not statistically significant (p = 0.323). Males: Mortality rates noticed an initial increase in the early 1990s (APC: 0.90 from 1990 to 1994; p < 0.001), followed by a stabilization 1994 to 2001 (APC: 0.04; p > 0.05), and then rose again from 2001 to 2005 (APC: 1.01; p < 0.001) and 2005 to 2010 (APC: 1.34; p < 0.001). A significant decline followed from 2014 to 2019 (APC: -1.46; p < 0.001), with an overall AAPC of -0.07% (95% CI: -0.108 to -0.032; p < 0.05). Conclusions: Over the last three decades, MPN-related mortality in the United States has demonstrated an initial increase followed by periods of stabilization and significant declines, particularly after 2014. Both males and females experienced mortality reductions in recent years, likely reflecting advancements in therapeutic strategies and improved disease management. Further investigations into gender-specific and global trends may provide additional insights into optimizing treatment and care for MPN patients.