In MDS, circulating galectin-9 levels are associated with increased risk of leukemic transformation by protecting tumor cells from CD8+ T cell and Natural Killer (NK) cell-mediated cytotoxicity (Asayama T et al., 2017; Gonçalves Silva I et al., 2017; Wolf Y et al., 2020). Here, LGALS9 is linked to myelodysplastic syndrome.