5q-: does longer survival of female patients explain the preponderance

Cases with deletion of part of the long arm of chromosome 5 (5q-) and a myeloid hemopoietic disorder show a marked female preponderance. We analysed the female preponderance of 328 published cases of myelodysplastic syndromes (MDS) or acute myeloid leukemia (AML). MDS without clinical or cytogenetic progression shows by far the highest frequency in female patients. Cases with advanced MDS and/or chromosome aberrations in addition to 5q- show low to moderate preponderance. Female preponderance was found to correlate positively with relative survival: in the group with the highest frequency women survived significantly longer than men. In groups with lower preponderances the survival of the two sexes gradually converged. These data suggest that in 5q- related disorders the female preponderance is a consequence of increased female survival.