# Unique Gender-Related Characteristics and Differences of Chronic Myeloid Leukemia Patients in Azerbaijan: A Retrospective Cohort Study

## TL;DR

This study finds that women with chronic myeloid leukemia in Azerbaijan have better treatment responses and survival rates compared to men, highlighting gender as an important factor in disease management.

## Contribution

The study identifies unique gender-related differences in CML patients in Azerbaijan, including female predominance and better outcomes in women.

## Key findings

- Female CML patients had smaller spleen sizes, lower hemoglobin, and higher platelet counts compared to males.
- Imatinib response and overall survival were significantly better in female patients.
- Male patients had more ABL kinase domain mutations, including the T315I mutation.

## Abstract

Objective: The objective of this study is to evaluate gender-related demographic, clinical, and molecular differences, and imatinib response in patients with chronic myeloid leukemia (CML) in Azerbaijan.

Setting: The study was carried out at National Hematology and Blood Transfusion Center, Baku, Azerbaijan.

Period: This is a retrospective data analysis carried out from January 2008 to December 2023.

Methods: A total of 763 patients with Ph+ CML were included. Case records were reviewed for demographic data, disease phase, risk group, clinical manifestation, molecular characteristics, and response to imatinib. Genetic mutations were analyzed in 163 patients.

Results: A total of 763 CML patients were analyzed, with a female predominance (54%) observed, an atypical trend compared to global data. Female patients had significantly smaller spleen sizes, lower hemoglobin, and higher platelet counts than male patients. Imatinib response was better in female patients (55.2%) compared to male patients (44.8%) (p = 0.03). ABL kinase domain mutations were significantly more frequent in male patients (21.3%) than in female patients (six percent) (p = 0.004), with T315I mutation also higher in male patients (p = 0.036). Survival analysis showed significantly better overall survival in female patients (p = 0.038), although subgroup differences by risk category were not statistically significant.

Conclusion: This study highlights significant gender-related differences in CML patients in Azerbaijan, including a unique female predominance, better treatment response, and superior survival outcomes in women. These findings underscore the need to consider gender as a relevant factor in CML prognosis, treatment planning, and future research.