Gender Disparities in Health-Related Quality of Life in Patients With Chronic Lymphocytic Leukemia: Impact of Treatment Modality

In chronic lymphocytic leukemia (CLL), treatment initiation is deferred until clinical symptoms emerge, aiming to minimize treatment-related burden and maintain health-related quality-of-life (QoL). We examined gender differences in QoL among patients undergoing active surveillance versus targeted therapies. Participants completed the Functional Assessment of Cancer Therapy-Leukemia (FACT-Leu) Questionnaire, and the score was derived from the FACT-General (FACT-G) and leukemia-specific concerns (Leu-Subscale). Comparisons between treatment groups were conducted using Student's t-test, stratified by sex. Among 210 participants, 63 were under surveillance, 115 in treatment, and 32 post-treatment. Among men, the surveillance group reported better physical well-being (mean: 25.2 vs. 19.7, p < 0.001), Leu-Subscale (mean: 51.5 vs. 42.8, p = 0.002), and FACT-Leu (mean: 135.9 vs. 120.5, p = 0.02) compared to the active treatment group. In contrast, women in surveillance reported lower social well-being (mean: 18.9 vs. 22.5, p = 0.008); emotional well-being (mean: 15.5 vs. 18.2, p = 0.003); FACT-G (mean: 74.6 vs. 83.3, p = 0.009); and FACT-Leu (mean: 116.7 vs. 128.3, p = 0.014) compared to the active treatment. A significant interaction was observed between treatment group and sex in the emotional well-being subscale. In conclusion, men in surveillance reported better overall QoL than those in active treatment, whereas women in active treatment experienced better overall QoL than those in surveillance. These findings highlight the importance of gender-specific approaches to improve health-related QoL in CLL care.