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  • Review Article
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The global epidemiology of acute myeloid leukaemia

Nature Reviews Clinical Oncology volume 23, pages 107–120 (2026)Cite this article

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Abstract

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.

Key points

  • The global incidence of acute myeloid leukaemia (AML) has increased substantially over the past three decades, largely reflecting population ageing, improved diagnostics and enhanced cancer registry reporting.

  • The incidence of AML as well as the outcomes of patients vary widely across regions, with high-income countries reporting higher incidences but markedly lower mortality compared with resource-limited settings.

  • Multiple risk factors contribute to AML development, including germline predispositions, prior cytotoxic therapy, environmental exposures and clonal haematopoiesis.

  • Demographic and socioeconomic disparities influence AML incidence and survival, with older age and lower socioeconomic status associated with worse outcomes.

  • Therapeutic advances, including targeted agents and improved access to transplantation, have significantly improved survival in developed countries although implementation remains limited in low-income and middle-income regions.

  • Future global efforts should focus on strengthening cancer registries, expanding access to diagnostics and clinical trials, and leveraging artificial intelligence to reduce disparities and improve AML surveillance.

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Fig. 1: Age-standardized incidence rates of AML by country.
Fig. 2: Demographic patterns of AML incidence in the USA.
Fig. 3: Age-adjusted acute myeloid leukaemia mortality rates in the USA, 2000–2023.
Fig. 4: Timelines of approvals for novel treatments of AML.

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Acknowledgements

The work of the authors is partially supported by a grant from the Edwards P. Evans Foundation. The authors used an artificial intelligence-based tool designed for scholarly writing, specifically ‘Paperpal’, to assist in refining the language and improving the writing quality. No artificial intelligence tools were used to summarize the content or any other form of writing. The authors take full responsibility for the contents of this manuscript.

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Authors and Affiliations

  1. Department of Hematology, Miami Cancer Institute, Baptist Health, South Florida, Miami, FL, USA

    Firas El Chaer

  2. Section of Medical Oncology and Hematology, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA

    Jan P. Bewersdorf, Maximilian Stahl & Amer M. Zeidan

  3. Yale Cancer Center, New Haven, CT, USA

    Jan P. Bewersdorf, Maximilian Stahl & Amer M. Zeidan

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  1. Firas El Chaer
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Correspondence to Amer M. Zeidan.

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Competing interests

F.E.C. has acted as a consultant and/or adviser of AbbVie, Amgen, the Association of Community Cancer Centers, Bristol Myers Squibb (BMS), CTI BioPharma, Daiichi Sankyo, DAVA Oncology, Geron, MorphoSys, Novartis, PharmaEssentia, Sobi, Sumitomo Pharma Oncology, Syndax and Taiho Oncology; he also received a travel grant from DAVA Oncology. M.S. has acted as a consultant and/or adviser of Boston Consulting, BMS, Dedham group, GSK, GLG Insights, Kymera, Kura, Novartis, Rigel, Sierra Oncology, Sobi and Syndax; has participated in CME activity for Clinical Care Options, Curis Oncology, Haymarket Media and Novartis; and is a member of the Medical Safety Monitoring Board for Keros Pharmaceuticals. A.M.Z. has participated in advisory boards, consulted for, participated in clinical trial committees for and/or received honoraria from AbbVie, Agios, Akesobio, Amgen, Astellas, Beigene, BioCryst, Boehringer-Ingelheim, Celgene/BMS, Chiesi/Cornerstone Biopharma, Daiichi Sankyo, Dr Reddy, Epizyme, Faron, Fibrogen, Genentech, Geron, Glycomimetics, Gilead, GSK, Janssen, Jasper, Karyopharm, Keros, Kura, Kyowa Kirin, Notable, Novartis, Orum, Otsuka, Pfizer, Regeneron, Rigel, Seattle Genetics, Shattuck Labs, Schrodinger, Syndax, Syros, Servier, Takeda, Treadwell, Taiho, Vincerx, and Zentalis. J.P.B. declares no competing interests.

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El Chaer, F., Bewersdorf, J.P., Stahl, M. et al. The global epidemiology of acute myeloid leukaemia. Nat Rev Clin Oncol 23, 107–120 (2026). https://doi.org/10.1038/s41571-025-01099-7

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