The global burden of leukemia, 1990–2021: a systematic analysis of prevalence, DALYs, and risk factors from the global burden of disease study

Leukemia, a prevalent hematologic malignancy, imposes a substantial global health burden and shows marked epidemiological heterogeneity across regions, ages, sexes, and subtypes. Using data from the Global Burden of Disease Study 2021 (GBD 2021), we systematically assessed trends in leukemia prevalence and disability‐adjusted life years (DALYs) across 204 countries and territories from 1990 to 2021. Global analyses revealed a 28.0% increase in leukemia cases alongside a 16.2% decline in DALYs over the study period. A bimodal age distribution was observed, with peaks in early childhood (0–4 years) and older adulthood (≥ 70 years), and males consistently exhibited higher DALY rates than females. Subtype‐specific analyses identified chronic lymphocytic leukemia (CLL) as the most prevalent subtype, whereas acute myeloid leukemia (AML) contributed the largest proportion of DALYs (37.7%), with notable reductions observed in acute lymphoblastic leukemia (ALL) and chronic myeloid leukemia (CML). Geographic and SDI‐stratified trends showed declines in high‐SDI regions but rising burdens in low‐SDI settings. Risk attribution analyses indicated high body mass index (6.8%), tobacco use (6.7%), and occupational carcinogen exposure (1.1%) as major modifiable contributors. These findings suggest that therapeutic progress, including targeted therapies, stem cell transplantation, and improved chemotherapy, likely underlies part of the observed DALY reductions, though benefits remain uneven across regions. Future frameworks should also integrate environmental and infectious determinants to capture a more comprehensive risk profile. Tailored strategies emphasizing early detection, equitable treatment access, and prevention of modifiable risks are essential to reduce global disparities and improve outcomes in leukemia care.