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

Abstract

Since its inception, the Hemoglobin, Albumin, Lymphocyte, Platelet Score (HALP) has gained attention as a new prognostic biomarker to predict several clinical outcomes in a multitude of cancers. In our review, we searched PubMed for articles between the first paper on HALP in 2015 through September 2022, yielding 32 studies in total that evaluated HALP's association with various cancers, including Gastric, Colorectal, Bladder, Prostate, Kidney, Esophageal, Pharyngeal, Lung, Breast, and Cervical cancers, among others. This review highlights the collective association HALP has with demographic factors such as age and sex in addition to TNM staging, grade, and tumor size. Furthermore, this review summarizes HALP's prognostic ability to predict overall survival, progression-free survival, recurrence-free survival, among other outcomes. In some studies, HALP has also been able to predict response to immunotherapy and chemotherapy. This review article also aims to serve as a comprehensive and encyclopedic report on the literature that has evaluated HALP as a biomarker in various cancers, highlighting the heterogeneity surrounding HALP's utilization. Because HALP requires only a complete blood count and albumin - already routinely collected for cancer patients - HALP shows potential as a cost-effective biomarker to aid clinicians in improving outcomes for immuno-nutritionally deficient patients.

M6A methylation of FKFB3 reduced pyroptosis of gastric cancer by NLRP3

“…With the continuous emergence of new theories and technologies in modern molecular biology, the research scope of molecular epidemiology of GC has become increasingly extensive and in-depth [34–36]. Exploring the mechanisms of key enzymes in the Warburg effect and identifying key factors that influence GC progression.…”

Combining SIRI and AFR to predict early serious complications and recurrent or metastases after respectable gastric cancer

“…Lymphocytes played a part in immunologic surveillance and were contributory to identi cation and destruction 25 . Importantly, a biochemical alteration of T cells can modulate cellular activities and promote tumor progression 26 .…”

Evaluating the baseline hemoglobin, albumin, lymphocyte, and platelet (HALP) score in the United States adult population and comorbidities: an analysis of the NHANES

“…This remained true across different tumor types and TNM staging. Farag et al ( 2 ) summarized the findings of many of these individual papers and highlighted the heterogeneity of the “optimal threshold” at which HALP is most predictive for individual cancer types. Our study adds context to how these optimal thresholds may be interpreted and compared to the averages in the general US population with and without comorbidities across sex and other demographic factors.…”

“…Hence, researchers worldwide are interested in harnessing inflammatory and nutritional measurements to predict outcomes and stratify risks for patients with various conditions and perioperatively. The HALP score was developed to provide a combined assessment of these factors, showing promise in its prognostic utility in numerous cancers ( 2 ). However, the lack of a standardized threshold for this score has led to considerable heterogeneity in disease-specific HALP thresholds among different study cohorts.…”