Serum soluble CD25, Galectin-9, and CXCL9 as immunological markers differentiating complete remission from refractory acute myeloid leukemia.
CXCL9 levels can accurately distinguish refractory acute myeloid leukemia from remission.
Serum soluble CD25, Galectin-9, and CXCL9 as immunological markers differentiating complete remission from refractory acute myeloid leukemia.
Acute myeloid leukemia (acute myeloid leukemia) remains an aggressive hematologic malignancy with heterogeneous responses to induction chemotherapy.
To evaluate whether serum soluble CD25 (sCD25), galectin-9 (Gal-9), and CXCL9 differ between acute myeloid leukemia patients in complete remission, refractory acute myeloid leukemia patients, and healthy controls, and to assess their discriminative performance for refractory versus complete remission status.
In this single-center case-control study, 155 participants were enrolled (50 healthy controls, 55 AMLCR, 50 AML-Refractory).
CXCL9 levels accurately distinguish acute myeloid leukemia that resists treatment from remission
Serum sCD25 and Gal-9 were significantly elevated in refractory patients compared with complete remission and controls (adjusted p < 0.001 for both), whereas CXCL9 was highest in the complete remission group and lowest in refractory patients (adjusted p < 0.001).
A combined logistic regression model incorporating all three markers yielded cross-validated AUC = 0.96 (95% CI: 0.93-0.99); the improvement over CXCL9 alone did not reach statistical significance (DeLong p = 0.31).
sCD25, Gal-9, and CXCL9 collectively describe two complementary immunological axes in acute myeloid leukemia chronic activation/exhaustion (sCD25, Gal-9) and effector-cell trafficking (CXCL9) and robustly discriminate refractory from remission status in this cross-sectional cohort.
Prospective longitudinal studies are required before these markers can be recommended for prognostic use or clinical decision-making.