Trends in mortality due to aplastic anemia in the United States, 1999-2020: a center for disease control wonder analysis

Background Acquired aplastic anemia is a rare, life-threatening hematologic disorder characterized by immune-mediated bone marrow failure. Despite therapeutic advancements that have increased survival, evaluating contemporary mortality trends in the United States remains important to inform clinical practice and health policy. Objectives This study examined aplastic anemia-related mortality trends, demographic disparities, and geographic variation among United States adults from 1999 to 2020. Methods Death certificate data from the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research database were analyzed for adults aged 25 years and older. Age-adjusted mortality rates per 100,000 persons and annual percent changes were calculated across years, sex, race, ethnicity, and geographic regions. Place of death and state-level social vulnerability index correlations were also evaluated. Results Aplastic anemia was recorded in 107,975 deaths from 1999 to 2020. The national age-adjusted mortality rate decreased initially from 1999 to 2002, remained stable until 2015, and increased through 2020. Men consistently demonstrated higher age-adjusted mortality rates than women. Non-Hispanic Black or African American individuals had the highest mortality rates among racial groups. Mortality was higher in non-metropolitan areas and the Midwest region. Mortality varied widely across states, whereas state-level social vulnerability was not associated with mortality rates. Conclusions Following a period of stability, aplastic anemia-related mortality has increased in the United States since 2015. Disparities persist across sex, race, urbanization, and geographical region.