Clinical application of HALP score in the determination of nodal non-Hodgkin lymphoma prognosis

Abstract

Introduction: Non-Hodgkin’s lymphomas (NHL) are hematopoietic tumors that develop from the malignant proliferation of the lymphatic tissue. The onset of NHL can occur in any organ and tissue, at the same time the most frequent localization is represented by the primary involvement of the lymph nodes (52-70%). The hemoglobin, albumin, lymphocytes, and platelets compose a score (HALP score), have recently been evaluated to predict the prognosis of cancer patients. However, there are limited reports of the use of HALP score in the determination of survival prognosis with NHL. Objective: This study aims to appreciate the usefulness of the HALP score in the determination of overall survival (OS) indicators in patients with nodal non-Hodgkin’s lymphomas. Material and methods: 57 patients diagnosed with nodal NHL in the Oncology Institute of the Republic of Moldova have been evaluated. The HALP score was calculated using formula: hemoglobin (g/L) × albumin (g/L) × lymphocytes (%) / platelets (/L). Results: Out of the patients enrolled in study 35 (61.4 %) were female. Aggressive lymphomas were diagnosed in 45 cases (78.9%), and indolent lymphomas in 12 patients (21.1%). On receiver operating characteristic curve (ROC) analysis, the predictive ability of the HALP score to envisage the risk of unfavorable events was significant (p= 0.038; AUC:0.685). The cut off value based on ROC was 583,5. As a result, it was observed that in case of aggressive NHLs HALP patients with a low HALP score have a shorter period of OS: median OS-13(4,4) months compared with the group of patients with high HALP score where the median OS was not reached, p=0,049. In contrast, in indolent lymphomas, HALP score failed to show significant differences in survival between groups of patients with high or low HALP score(p=0,081). Conclusions: The HALP score, appears to be a valuable tool in determining the prognosis of patients with nodal NHL. A low HALP score was associated with lower OS rates - 13(±4,4) months in case of aggressive NHLs. (p=0,049). However, in case of indolent NHLs HALP score failed to perform as a useful prognostic score in the estimation of OS.