Plasma levels of galectin-9 have been shown to be significantly elevated in patients with acute leukemia transformed from MDS (AL-MDS) or with refractory anemia, in comparison to healthy controls, suggesting that galectin-9 production may be induced in MDS patients with advanced-stage disease, and that the TIM-3/galectin-9 axis may have a role in disease progression and leukemic transformation [28]. This evidence concerns the gene HAVCR2 and myelodysplastic syndrome.