HALP score and GNRI: Simple and powerful prognostic markers in diffuse large B-cell lymphoma

Diffuse large B cell lymphoma (DLBCL) is the most common subtype of non-Hodgkin lymphoma. It is a heterogeneous group of diseases that may need very aggressive treatment in some cases. Prognostic evaluation is very important in determining the best treatment. However, in some clinics, access to genetically based and expensive diagnostic methods is limited. In this study, we analyzed the prognostic value of Hemoglobin, Albumin, Lymphocyte and Platelet (HALP) Score and Geriatric Nutritional Risk Index (GNRI) in DLBCL patients. 201 Patients with newly diagnosed DLBLC between 2005 and 2022 were retrospectively evaluated. Optimal cutoff points for the HALP score and the GNRI were calculated with the receiver operating characteristic curve analysis. Kaplan-Meier method was used to compare survival and disease-free survival times between HALP score groups. In the receiver operating characteristic curve analysis, the cutoff points were found 26.17 for HALP, and 99.17 for GNRI. Groups with lower HALP scores and lower GNRIs had significantly shorter overall survival and disease-free survival. Univariate analyses showed that lower HALP score, lower GNRI and higher lactic dehydrogenase, Ann-Arbor stage, International Prognostic Index (IPI), National Comprehensive Cancer Network-IPI and Revised-IPI scores were associated with worse survival rates (P < .05). According to the results of the multivariate Cox regression model, patients with HALP score ≤ 26.17 (OR: 2.32; 95%CI: 1.31-4.11 P = .004) increased the risk of death (P = .001, -2 loglikelihood = 506.15). Similarly, a GNRI score ≤ 99.17 was significantly correlated with worse survival outcomes (P < .001). HALP score and GNRI score are reliable, simple and easily accessible indices that can be used to predict the prognosis of DLBLC patients. DLBLC patients with low HALP score and low GNRI level may be associated with short survival and early nutritional support should be considered.