Epidemiological Landscape of Hematological Malignancies: Global Trends and Health Estimations

This chapter evaluate the identification of the epidemiological patterns of HM in the Republic of Moldova and the evaluation of their global epidemiological trends and disease burden issues. Hematological malignancies (HM) are a public health problem. The pattern and distribution of diagnosed hematological cancers vary depending on age, sex, geography, and ethnicity suggesting the involvement of genetic and environmental factors for the development of these diseases.

This is an epidemiological, observational, cross-sectional and big data analytics study. The diagnosis was proved in all cases by histopathological, cytological, cytogenetic, molecular and immunophenotyping examinations. The qualitative type researches were performed and enriched by the narrative synthesis of the data from the specialized international bibliographic sources and official statistics concerning HM. The chapter summarized and systematized the primary studies, dedicated to the epidemiological landscape and global disease burden of HM. In order to obtain the scheduled objectives, the scientific medical publications were searched via GoogleSearch, PubMed, Z-library, NCIB, Medscape, Hinari database, by the keywords: “hematological malignancies”, “chronic leukemias”, “malignant lymphomas”, “epidemiological patterns”, “incidence”, “mortality”, “disability-adjusted life-years”, “disease burden”, “COVID-19 infection”, “management”. Forty-six relevant primary sources were identified and selected, according to the significance of the impact score under the scientific and reproducible approach to the disuted subject, with the subsequent data extraction, evaluation and interpretation. Intending to minimize the erratum, a copy of the data extraction sheet was initially formed, sharing all the elements to be extracted from the primary studies. The decrease of the incidence of HM in 2020 as compared to 2016 and 2017 can be explained by labor population migration and the impact of the COVID-19 pandemic on patients’ addressability. The average age of men was 54.7 years, of women – 57.9 years. In both gender groups, the patients aged between 50 and 79 years prevailed (males – 65%, females – 72.5%), partially fitting the category of a workable population. The gender analysis of morbidity showed that the male's rate was 51.5%, the female's rate – 48.5% in 2019. Within 2 years males were 50.4%, females – 49.6%. In the recent epidemiological context, the association of COVID-19 infection with HM proved to be of scientific and practical interest, taken into account an apparently immunocompromised status of patients with lymphoproliferative and myeloproliferative neoplasms.

The epidemiological study found that the Republic of Moldova had a slightly lower HM morbidity than countries in West Europe, primarily as a result of the migration of a workable population. The patients with chronic leukemias and malignant lymphomas, male gender and age categories of 50-79 years constituted the global epidemilological landscape. The narrative analysis of the literature has proved that patients with HM may experience a considerable disease burden with negative impact on their employment status, working productivity, annual household income and epidemiological susceptibility.