Shared decision-making, treatment priorities and communication gaps in chronic lymphocytic leukemia: an Israeli national survey

A national cross-sectional survey of 267 Israeli patients with chronic lymphocytic leukemia (CLL) examined patient–hematologist communication, shared decision-making (SDM), and treatment priorities. Perceived adequacy of information was moderate at diagnosis (mean 2.9/5) and higher during treatment selection (mean 3.5/5). Physician-led decision-making predominated (58%), while SDM was reported by only 29.5% of patients; venetoclax-exposed patients were significantly more likely to participate in SDM (OR = 4.93, p = 0.008). Treatment priorities varied, with complete response (36.5%) and quality-of-life (29%) most frequently endorsed; BTKi-exposed patients disproportionately prioritized quality-of-life over response or survival (OR = 3.5, p = 0.027). Overall communication satisfaction and treatment adherence were high, yet 24% of patients lacked any contact channel with their hematologist outside clinic visits. Gender-related differences in communication comfort were also observed. These findings identify important gaps in SDM implementation and communication continuity in modern CLL management that warrant structured interventions.