Prognostic value of HALP score and Systemic Immune-inflammationIndex in multiple myeloma

Creative Commons License

Özlü C., Yalçın C., Gönderen A., Acet A., Kaçmaz Kipergil D.

Journal of current hematology & oncology research, cilt.4, sa.3, ss.74-79, 2026 (TRDizin)

Özet

ABSTRACT

Aims: Multiple myeloma (MM) is a heterogeneous hematologic malignancy requiring reliable prognostic stratification.

Inflammation- and nutrition-based biomarkers such as the hemoglobin-albumin-lymphocyte-platelet (HALP) score and

Systemic Immune-inflammation Index (SII) have been proposed as accessible prognostic indicators. This study evaluated their

prognostic value and compared their performance with the International Staging System (ISS).Methods: This retrospective study included 54 patients with newly diagnosed MM. Baseline clinical and laboratory parameters

were recorded at diagnosis. Overall survival (OS) was defined as the time from diagnosis to death from any cause or last followup. Survival outcomes were analyzed using Kaplan-Meier and log-rank tests, and independent predictors were assessed using

multivariate Cox regression analysis. Receiver operating characteristic (ROC) analysis with the Youden index determined

optimal cut-off values.Results: The median age was 68 years (range, 40-85), and 53.7% of patients were male. According to ISS, 33.3% of patients

were stage I, 46.3% stage II, and 20.4% stage III. During follow-up, 7 patients (13.0%) died. Higher ISS stage was significantly

associated with mortality (p=0.007) and remained an independent predictor of OS in multivariate analysis (HR=3.84, 95% CI:

1.33-11.05, p=0.0127). ROC analysis demonstrated the strongest discriminative performance for ISS (AUC=0.793), compared

with HALP (AUC=0.608) and SII (AUC=0.371). Optimal cut-off values were 3.0 for ISS, 32.3 for HALP, and 2887.5 for SII.

Kaplan-Meier analysis showed significantly inferior survival in patients with ISS ≥3 (log-rank p=0.001), whereas HALP and SII

did not significantly stratify OS (p=0.901 and p=0.348, respectively).Conclusion: Although HALP showed a non-significant trend toward poorer survival at lower values, inflammation-based

indices provided limited additional prognostic value beyond established staging systems.Keywords: Multiple myeloma, overall survival, HALP score, Systemic Immune-inflammation Index