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New research · Hematology
Clinical immunology (Orlando, Fla.) · 2d
Case-controlClinical immunology (Orlando, Fla.) · 2026

Serum soluble CD25, Galectin-9, and CXCL9 as immunological markers differentiating complete remission from refractory acute myeloid leukemia.

Abdullah Salim Al-Karawi, Ali Saad Al-Budairi, Ali M Atoom
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HematologyCase-control

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.

Abdullah Salim Al-Karawi et al. · Clinical immunology (Orlando, Fla.) · 2026
Background

Acute myeloid leukemia (AML) remains an aggressive hematologic malignancy with heterogeneous responses to induction chemotherapy.

Purpose

To evaluate whether serum soluble CD25 (sCD25), galectin-9 (Gal-9), and CXCL9 differ between AML patients in CR, refractory AML patients, and healthy controls, and to assess their discriminative performance for refractory versus CR status.

Methods

In this single-center case-control study, 155 participants were enrolled (50 healthy controls, 55 AMLCR, 50 AML-Refractory).

n = 155 participants
Results

CXCL9 levels accurately distinguish AML that resists treatment from remission

AUC 0.96 (95% CI 0.93 to 0.99)
null = 00.930.99
CI excludes the null - significant
More results

Serum sCD25 and Gal-9 were significantly elevated in refractory patients compared with CR and controls (adjusted p < 0.001 for both), whereas CXCL9 was highest in the CR group and lowest in refractory patients (adjusted p < 0.001).

More results

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).

“
Conclusion · 1 of 2

sCD25, Gal-9, and CXCL9 collectively describe two complementary immunological axes in AML chronic activation/exhaustion (sCD25, Gal-9) and effector-cell trafficking (CXCL9) and robustly discriminate refractory from remission status in this cross-sectional cohort.

Conclusion · 2 of 2

Prospective longitudinal studies are required before these markers can be recommended for prognostic use or clinical decision-making.

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