Background: Multiple myeloma, traditionally considered a disease of older adults, is increasingly recognized among adolescent and young adult (AYA) populations. However, little is known about long-term mortality trends and disparities across sex and socioeconomic strata globally. This study aimed to assess temporal changes in mortality and disability-adjusted life years (DALYs) attributable to multiple myeloma among AYAs, stratified by sex and socio-demographic index (SDI) regions, from 1990 to 2021.

Methods: We used data from the Global Burden of Disease Study-2021 to extract annual age-standardized mortality rates (AAMRs) and DALY rates due to multiple myeloma in individuals aged 15–39 years for each year from 1990 to 2021. Data were stratified by sex and SDI-based regions. Average Annual Percent Change (AAPC) with corresponding 95% confidence intervals (CIs) and p-values were calculated using log-linear regression models for each subgroup over the study period. Statistical significance was defined at p<0.05.

Results: In 2021, global AAMRs for deaths due to multiple myeloma among AYAs reached 0.0625 per 100,000 among males and 0.0434 among females, compared to 0.0387 and 0.0276 in 1990, respectively. This translated into significant increases in mortality, with global AAPCs of 1.38% (95% CI: 1.22 to 1.54; p < 0.001) for males and 1.25% (95% CI: 1.08 to 1.42; p < 0.001) for females. In contrast, high-SDI regions showed a stabilization or modest decline in AAMRs. For example, among females in high-SDI settings, AAMRs remained relatively stable (0.0438 in 1990 vs. 0.0451 in 2021), with an AAPC of –0.20% (95% CI: –0.35 to –0.05; p = 0.016), indicating a statistically significant decline. Male AAMRs in high-SDI regions were slightly higher (0.0675 in 1990 vs. 0.0710 in 2021), but the trend was not statistically significant (AAPC: –0.02%; 95% CI: –0.15 to 0.12; p = 0.80). In contrast, high-middle SDI regions experienced pronounced increases in mortality, especially among males (AAPC: 2.01%; 95% CI: 1.81 to 2.21; p < 0.001), with AAMRs nearly doubling from 0.0484 in 1990 to 0.0971 in 2021. Females in the same region showed a similarly strong upward trend (AAPC: 1.68%; 95% CI: 1.44 to 1.92; p < 0.001). Among low-SDI regions, though the absolute AAMRs remained lower, the increasing trend was also evident (AAPC: 1.05%; 95% CI: 0.94 to 1.16; p < 0.001). Patterns in DALYs closely mirrored those observed for mortality. Globally, DALY rates among males increased from 1.42 to 2.34 per 100,000, with an AAPC of 1.50% (95% CI: 1.31 to 1.69; p < 0.001), while females exhibited an increase from 1.01 to 1.78 (AAPC: 1.38%; 95% CI: 1.18 to 1.57; p < 0.001). In high-SDI countries, DALY trends were more stable, particularly for females (AAPC: –0.23%; 95% CI: –0.40 to –0.06; p = 0.009), while high-middle and middle SDI regions experienced the most pronounced increases.

Conclusion: Mortality and DALY burdens due to multiple myeloma in AYA individuals have risen globally over the past three decades, with the sharpest increases observed in middle- and high-middle-income settings. High-income regions demonstrated more stable or declining trends, particularly among females. These findings highlight widening global disparities in AYA multiple myeloma outcomes and emphasize the urgent need for targeted surveillance, early detection, and equitable access to diagnostics and therapeutics across socioeconomic strata.

This content is only available as a PDF.
2025
Sign in via your Institution