# Multiple myeloma in adolescents and young adults(AYA): global epidemiological trends, risk factors, and future projections (1990–2040)

## TL;DR

This study examines rising multiple myeloma cases in young adults globally from 1990 to 2040, highlighting risk factors like obesity and the need for early detection.

## Contribution

The study provides global epidemiological trends and future projections of multiple myeloma in adolescents and young adults using GBD data and statistical modeling.

## Key findings

- Global incidence and death rates of AYA MM increased from 1990 to 2021 with males and high-middle SDI regions most affected.
- High BMI contributed to 6.52% of MM-related deaths in 2021, emphasizing obesity as a modifiable risk factor.
- Projections suggest continued increases in incidence and mortality rates through 2040, with regional disparities highlighted.

## Abstract

Multiple myeloma (MM) is a hematological malignancy with increasing incidence among adolescents and young adults (AYAs) aged 15 to 39 years. This trend presents unique challenges related to long-term treatment effects, fertility, and late-onset complications. Risk factors include obesity, diabetes, environmental exposures, and genetic predispositions, with a higher incidence observed in males and individuals of African-American descent. This study aims to analyze global trends in MM incidence and mortality among AYAs from 1990 to 2021 and project future trends through 2040.

Using data from the Global Burden of Disease (GBD) 2021 study, we analyzed the age-specificincidence rate (IR), and death rate (DR) per 100,000 patient-years of AYA MM. Statistical modeling, including two sample t-test were done to estimate the standard deviations among each group, which is plugged into the denominator to compute the statistic. Auto-Regressive Integrated Moving Average (ARIMA) and Exponential Smoothing State Space (ETS) models were applied for projections.

In 2021, the global AYA MM incidence was 2536 cases (IR 0.09/100,000 patient-years), and deaths totaled 1579 (DR 0.05/100,000 patient-years). From 1990 to 2021, IR and DR increased (annual percentage change (APC) of 0.84 for IR and 0.60 for DR). Males exhibited higher rates and faster increases. High-middle SDI regions had the highest IR and DR, with Mauritius recording the highest national rates. High BMI contributed to 6.52% of MM-related deaths in 2021. Projections indicate rising IR and DR globally through 2040.

The increasing burden of AYA MM necessitates early detection, targeted treatments, and preventive measures addressing obesity and other modifiable risk factors. Reducing regional disparities through improved healthcare access is essential to mitigate the growing impact of MM.

The online version contains supplementary material available at 10.1007/s10552-026-02142-3.