Clinical Significance of Galectin-9 in Patients with Chronic Lymphocytic Leukemia | ||
| Zagazig University Medical Journal | ||
| Articles in Press, Accepted Manuscript, Available Online from 16 November 2025 | ||
| Document Type: Original Article | ||
| DOI: 10.21608/zumj.2025.435180.4276 | ||
| Authors | ||
| Heba Allah Elsayed AbdElrhman1; Rania Abdullah2; Ayman Fathy Arafa3; Hossam E. Salah1; Reham Mahmoud Ibrahim Mohamed Kassab* 4; Gehad Hamed2 | ||
| 1Professor of Clinical Pathology Department, Faculty of Medicine, Zagazig University, Egypt | ||
| 2Lecturer of Clinical Pathology Department, Faculty of Medicine, Zagazig University, Egypt | ||
| 3Professor of Internal Medicine Department, Faculty of Medicine, Zagazig University, Egypt | ||
| 4Clinical Pathology Department, Faculty of Medicine, Zagazig University, Egypt | ||
| Abstract | ||
| Background: Galectin-9 (Gal-9), an immune modulatory lectin that acts partly via the TIM‑3 pathway. Its clinical significance in chronic lymphocytic leukemia (CLL) remains incompletely defined. This study aimed to evaluate serum Gal-9 levels in CLL patients and explore their association with clinicobiological parameters and treatment response. Methods: Measurement of Gal-9 by ELISA in newly diagnosed 36 CLL patients and 36 healthy controls. Post-treatment follow-up assessed laboratory parameters and therapeutic response were performed to categorize patients as complete (CR), partial (PR), or no response (NR) according to IWCLL2008 2008 criteria. Results: CLL patients showed significantly higher serum Gal-9 levels than controls (137.69±58.36vs. 107.75±17.48pg/mL; p=0.01). Gal-9 was significant marked elevated in CD38-positive compared to CD38-negative cases and in patients harboring 17p deletion compared to those without (both p ≤0.006). Following therapy, TLC, lymphocyte count, LDH, and β2M declined significantly (all p<0.001), while Hb and platelets showed no significant change. Gal-9 was correlated positively with post-treatment β2M (r=0.44; p=0.006). Patients with poor treatment response exhibited the highest significant Gal-9 levels (NR: 201.19±66.39 pg/mL; PR: 120.53±22.14pg/mL; CR: 96.03±10.95 pg/mL; p<0.001). At a cut-off of >128.86 pg/mL, Gal-9 predicted non-response with an AUC=0.97 (95% CI: 0.91–1.02), sensitivity=90.9%, and specificity =96.0%. Conclusions: Serum Gal-9 was significantly elevated in CLL patients and associated with adverse prognostic factors (CD38 positivity, 17p deletion) and inferior treatment response. Gal-9 demonstrates excellent accuracy in predicting therapeutic resistance and may serve as a valuable biomarker for early risk stratification and individualized patient management. | ||
| Keywords | ||
| Chronic lymphocytic leukemia; Galectin-9 biomarker; CD38; 17p deletion | ||
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