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

J Cancer Res Ther. 2022 Apr-Jun;18(3):725-732. doi: 10.4103/jcrt.jcrt_174_21.

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.

Keywords: Albumin; diffuse large B-cell lymphoma; hemoglobin; lymphocyte; platelet; prognosis.

MeSH terms

  • Albumins / therapeutic use
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Cyclophosphamide / therapeutic use
  • Doxorubicin / therapeutic use
  • Hemoglobins
  • Humans
  • Lymphocytes / pathology
  • Lymphoma, Large B-Cell, Diffuse* / diagnosis
  • Lymphoma, Large B-Cell, Diffuse* / drug therapy
  • Lymphoma, Large B-Cell, Diffuse* / pathology
  • Prednisone / therapeutic use
  • Prognosis
  • Retrospective Studies
  • Rituximab / therapeutic use

Substances

  • Albumins
  • Hemoglobins
  • Rituximab
  • Doxorubicin
  • Cyclophosphamide
  • Prednisone