Li Na, Huang Jing, Xie Yuping, Feng You, Min Shihui, Zou Li-Qun
Department of Oncology, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China.
Department of Medical Oncology of Cancer Center, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, China.
Ann Hematol. 2025 Aug;104(8):4133-4140. doi: 10.1007/s00277-025-06272-7. Epub 2025 Aug 1.
Extranodal natural killer/T-cell lymphoma (ENKTL) is an aggressive disease with grim prognosis. The hemoglobin, albumin, lymphocyte, and platelet (HALP) score has been identified as a predictive marker for prognosis in various malignancies. However, the prognostic significance of the HALP score in the context of ENKTL has yet to be established.
Our objective was to assess the predictive power of the initial HALP score for ENKTL patients regarding their prognosis.
We conducted a retrospective analysis of 296 early-stage, low-risk ENKTL patients who were newly diagnosed and treated with asparaginase-based therapies. We evaluated the significance of HALP score as a predictor of response to treatment, overall survival (OS), and progression-free survival (PFS).
The median follow‑up for all patients was 72 months. We identified that a low HALP score was associated with a poorer Eastern Cooperative Oncology Group (ECOG) performance status (PS), the presence of B symptoms, male gender, and increased lactate dehydrogenase (LDH) levels (all p < 0.05), as well as a suboptimal response to therapy (p = 0.006). In the prognostic index of natural killer cell lymphoma (PINK) model, low-risk ENKTL patients with a HALP score below 32.6 exhibited significantly worse 5-year OS at 51.8% compared to 75.5% for those with a HALP score of 32.6 or above (p < 0.001), and 5-year PFS at 47.1% compared to 69.9% (p < 0.001). Integrating Epstein-Barr virus (EBV)-DNA titer into the PINK model led to the development of an additional prognostic index, the PINK-E model. According to this model, low-risk ENKTL patients with a HALP score below 32.6 had significantly poorer 5-year OS at 46.0% compared to 73.1% for those with a HALP score of 32.6 or above (p < 0.001), and 5-year PFS at 40.8% compared to 68.5% (p < 0.001).
Low HALP score was associated with unfavorable clinicopathological characteristics of ENKTL patients with low-risk and early-stage disease, suggesting that it may serve as an independent, negative prognostic indicator.
结外自然杀伤/T细胞淋巴瘤（ENKTL）是一种侵袭性疾病，预后不佳。血红蛋白、白蛋白、淋巴细胞和血小板（HALP）评分已被确定为多种恶性肿瘤预后的预测标志物。然而，HALP评分在ENKTL中的预后意义尚未确立。
我们的目的是评估初始HALP评分对ENKTL患者预后的预测能力。
我们对296例新诊断并接受基于天冬酰胺酶治疗的早期、低风险ENKTL患者进行了回顾性分析。我们评估了HALP评分作为治疗反应、总生存期（OS）和无进展生存期（PFS）预测指标的意义。
所有患者的中位随访时间为72个月。我们发现低HALP评分与较差的东部肿瘤协作组（ECOG）体能状态（PS）、B症状的存在、男性性别以及乳酸脱氢酶（LDH）水平升高相关（所有p<0.05），以及对治疗的反应欠佳（p=0.006）。在自然杀伤细胞淋巴瘤预后指数（PINK）模型中，HALP评分低于32.6的低风险ENKTL患者5年总生存率显著较差，为51.8%，而HALP评分32.6及以上的患者为75.5%（p<0.001），5年无进展生存率为47.1%，而后者为69.9%（p<0.001）。将爱泼斯坦-巴尔病毒（EBV）DNA滴度纳入PINK模型导致了另一个预后指数PINK-E模型的开发。根据该模型，HALP评分低于32.6的低风险ENKTL患者5年总生存率显著较差，为46.0%，而HALP评分32.6及以上的患者为73.1%（p<0.001），5年无进展生存率为40.8%，而后者为68.5%（p<0.001）。
低HALP评分与低风险、早期疾病的ENKTL患者不良的临床病理特征相关，表明它可能作为一个独立的负面预后指标。
