The global epidemiology of acute myeloid leukaemia

Acute myeloid leukaemia (AML) is an aggressive haematological malignancy with an incidence that increases with age and varies widely across regions owing to differences in risk factors, diagnostic capabilities, recording in cancer registries and access to health care. Despite improved outcomes over the past decade owing to the approvals of various novel therapies as well as improvements in supportive care and better access to, and safety of, allogeneic haematopoietic stem cell transplantation, progress has largely been confined to high-income countries. Patients in low-income or middle-income countries often remain reliant on older cytotoxic regimens, when available. The incidence of AML in high-income countries has increased over the past decades owing to population ageing in many of these countries as well as improved access to diagnostics. By contrast, AML has a lower incidence but is associated with higher mortality and morbidity in most low-income or middle-income countries. Multiple risk factors predispose individuals to AML, including germline variants, environmental and lifestyle factors, prior exposure to chemotherapy and radiation, and certain medical conditions and comorbidities. In this Review, we highlight global trends in the incidence, risk factors, demographic disparities and treatment-related outcomes of patients with AML across diverse geographical regions. We also outline the urgent need to improve the cancer registry infrastructure, expand global surveillance, leverage artificial intelligence for data analysis and promote equitable access to clinical trials.