Prognostic value of the hemoglobin, albumin, lymphocyte, platelet score in metastatic mesothelioma: a retrospective study

Malignant mesothelioma is a rare but aggressive cancer with limited treatment options and poor prognosis. Hemoglobin, Albumin, Lymphocyte, Platelet (HALP) score, reflecting inflammation and nutritional status, is a potential prognostic marker in various cancers. Our study aimed to investigate the prognostic value of the HALP score in mesothelioma. Methods: This retrospective study included 68 metastatic mesothelioma patients diagnosed between 2015 and 2023. Clinical and laboratory data were collected, and HALP scores were calculated at the time of metastasis. Patients were divided into HALP-low and HALP-high groups based on the median HALP score. Overall survival (OS) and progression-free survival (PFS) were analyzed using the Kaplan-Meier method, and prognostic factors were assessed using univariate and multivariate analyses. Results: The median HALP score was 24.85. The median OS for the entire cohort was 11.59 months. Patients with low HALP scores had significantly worse OS (7.81 months) compared to those with high HALP scores (16.36 months) (p = 0.01). Similarly, median PFS was significantly shorter in the HALP-low group (7.29 months) compared to the HALP-high group (12.12 months) (p = 0.02). In multivariate analysis, low HALP score (p = 0.02) and de novo metastatic disease (p = 0.01) remained independent prognostic factors for OS. Conclusion: This study demonstrates that the HALP score is an independent prognostic biomarker in metastatic mesothelioma. Low HALP scores are associated with worse OS and PFS. Given its simplicity and cost-effectiveness, the HALP score may be a valuable tool for risk stratification and treatment decision-making in clinical practice.