The hemoglobin, albumin, lymphocyte, and platelet (HALP) score is a novel prognostic factor for patients with diffuse large B-cell lymphoma

Abstract

Context: The hemoglobin, albumin, lymphocyte, and platelet (HALP) score is a prognostic marker in several types of malignant tumors. The prognostic value of HALP score in diffuse large B-cell lymphoma (DLBCL) remains unknown. Aim: We aimed to determine the prognostic value of baseline HALP score in DLBCL patients. Subjects and Methods: We retrospectively analyzed data from 153 newly diagnosed DLBCL patients treated with R-CHOP or R-CHOP-like regimens at our university hospital center. We evaluated the significance of HALP score as a predictor of response to treatment, overall survival (OS), and event-free survival (EFS). Results: The median follow-up time for all patients was 40 months. Lower HALP score was found in patients with advanced stages of disease (P = 0.005) and in those with poor response to therapy (P = 0.004). Patients with a HALP score ≤20.8 had significantly worse 5-year OS (47.3% vs. 79.5%, P < 0.001) and 5-year EFS (40.6% vs. 76.7%, P < 0.001). These observations remained statistically significant in the multivariate Cox regression models independently of International Prognostic Index (IPI) and age. Conclusion: Lower HALP is associated with unfavorable clinicopathological characteristics of DLBCL and seems to be an IPI independent negative prognostic factor. HALP score can be easily and inexpensively applied to timely recognize DLBCL patients under higher risk of unwanted outcomes in everyday clinical practice.

What is hemoglobin, albumin, lymphocyte, platelet (HALP) score? A comprehensive literature review of HALP’s prognostic ability in different cancer types

“…In a 2021 study by Vlatka et al, the authors retrospectively queried 153 newly diagnosed diffuse large B-cell lymphoma patients receiving R-CHOP (Rituximab, Cyclophosphamide, Doxorubicin, Vincristine, and Prednisone) chemotherapy [ 80 ]. This study found that lower HALP was shown to be associated with unfavorable clinicopathological characteristics and a predictor of long term survival.…”

“…Xu et al, showed that low HALP was significantly associated with poor tumor differentiation and higher TNM staging in pancreatic cancer [ 60 ]. Vlatka et al, has demonstrated that diffuse large B-cell patients with higher HALP were more likely be Stage I/II while lower HALP scores predicted increased rate of TNM Stage III/IV [ 80 ]. Duran et al, found low HALP breast cancer patients were also more likely to have more advanced clinical stage at time of surgery [ 61 ].…”

“…The higher risk of treatment failure with a low HALP score indicates the value this pre-treatment biomarker can have on patient clinical outcomes. Higher HALP scores had better responses in complete and partial remission to treatment [ 80 ].…”

Nomogram Based on Hemoglobin, Albumin, Lymphocyte and Platelet Score to Predict Overall Survival in Patients with T3-4N0-1 Nasopharyngeal Carcinoma

“…In hematologic tumors, low HALP is associated with adverse clinicopathological features of diffuse large B-cell lymphoma and appears to be an independent adverse prognostic factor for International Prognostic Index. 46 Besides, HALP score is a valuable prognostic marker for patients with multiple myeloma. 47 A retrospective study with 319 pharyngeal cancer patients including nasopharyngeal carcinoma, oropharyngeal carcinoma and hypopharyngeal carcinoma indicated that HALP score was an independent factor for OS.…”

Development and validation of platelet-to-albumin ratio as a clinical predictor for diffuse large B-cell lymphoma

“…Thus, an elevated platelet count is considered as an inflammatory biomarker and reflects the inflammatory response in lymphoma patients. Furthermore, consumptive character of malignant lymphomas has significant impact on nutritional status and host immune system ( 16 ).…”