Trends in Chronic Myeloid Leukemia Mortality by Race, Age, and Gender in the United States Between 1999 and 2020

Background and objective Chronic myeloid leukemia (CML) represents a significant portion of leukemia cases annually in the United States. Despite advances in treatment, disparities in CML mortality persist across different demographic groups, particularly by race, age, sex, and social determinants of health. This study explores mortality trends by race, age, and gender in CML from 1999 to 2020 in the United States. Methods Mortality data for CML (ICD-10 code C92.1) were analyzed from the CDC Wonder Database (1999-2020). Age-adjusted mortality rates (AAMRs) were calculated per 100,000 persons and stratified by sex, race (White and African American), and adult age groups. Results While overall CML mortality rates declined after the introduction of tyrosine kinase inhibitors (TKIs) in 2001, disparities persist. Older adults, males, and African Americans exhibit higher mortality rates compared to their counterparts. African Americans' AAMR decreased from 0.7 in 1999 to 0.35 by 2008 (annual percent change (APC) of -8.5%, p < 0.01). White Americans had a larger reduction in AAMR, from 0.65 in 1999 to 0.3 by 2007 (APC of -10.0%, p < 0.01). Age-specific analyses highlighted a decrease in mortality across adult age groups. The oldest group, aged ≥85 years, had an AAMR of 5.25 in 1999, which decreased to 4.7 by 2020 but remained significantly higher than other age groups. Conclusions Despite the effectiveness of TKIs, significant disparities in CML mortality remain, particularly among older adults, males, and African Americans. Addressing these disparities requires a multifaceted approach, including better access to care, increased representation in clinical trials, and tailored interventions for each demographic group, which is critical to reducing these disparities and improving outcomes for all patients.