Several factors have been reported to contribute to differences in autosomal gene mutations between men and women in cancer, including increased defects in DNA damage response pathways in men, the effect of hormonal receptors on various cellular functions, and sex differences in the immune system.22, 23, 24 These mechanisms might also play a part in explaining sex-bias in myelodysplastic syndrome, but further investigation is necessary. Here, NR4A1 is linked to myelodysplastic syndrome.