JCHOR
Journal of Current Hematology & Oncology Research

The Journal of Current Hematology & Oncology Research regularly publishes internationally qualified research in hematology and oncology within the current scholarly knowledge.

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Original Article
Prognostic Value of HALP Score and Systemic Immune-Inflammation Index in multiple myeloma
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 follow-up. 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

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1. Shieh AC, Faraji N, Smith D, et al. Utility and clinical implications of appendicular skeleton magnetic resonance imaging in multiple myeloma: a single-institutional 15-year experience. J Comput Assist Tomogr. 2021;45(6):904-911. doi:10.1097/RCT.0000000000001221
2. Wang M, Yue X, Ding Y, et al. A nomogram based on circulating inflammatory factors for predicting prognosis of newly diagnosed multiple myeloma patients. J Inflamm Res. 2025;18:2077-2090. doi:10.2147/JIR.S492831
3. Palumbo A, Avet-Loiseau H, Oliva S, et al. Revised international staging system for multiple myeloma: a report from International Myeloma Working Group. J Clin Oncol. 2015;33(26):2863-2869. doi:10.1200/JCO.2015.61.2267
4. Rajkumar SV. Multiple myeloma: 2022 update on diagnosis, risk stratification, and management. Am J Hematol. 2022;97(8):1086-1107. doi:10.1002/ajh.26590
5. Kim DS, Yu ES, Kang KW, et al. Myeloma prognostic index at diagnosis might be a prognostic marker in patients newly diagnosed with multiple myeloma. Korean J Intern Med. 2017;32(4):711-721. doi:10.3904/kjim.2016.035
6. Huang X, Wu J, Li S, et al. Beyond ISS staging: the prognostic value of the Inflammation Prognostic Score Index (IPSI) in multiple myeloma. Hematology. 2025;30(1):2549959. doi:10.1080/16078454.2025.2549959
7. Sun YQ, Li QF, Zhang QK, et al. Significance of neutrophil/lymphocyte ratio in the prognosis of patients with multiple myeloma. Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2019;27(2):489-493. doi:10.1946/j.cnki.issn.1009-2137.2019.02.029
8. Nan H, Yang P, Wang L, et al. Prognostic significance of Systemic Immune-inflammation Index in patients with de novo non-M3 acute myeloid leukemia. J Inflamm Res. 2025;18:16331-16346. doi:10.2147/JIR.S552797
9. Ulaş Babacan Ö, Hasbek Z, Terzi H. Relationship of plasma cell infiltration rates with 18F-FDG PET/CT data and hematological parameters in multiple myeloma. Mol Imaging Radionucl Ther. 2025; 34(1):26-30. doi:10.4274/mirt.galenos.2024.78557
10. Zhang C, Hou K, Lin D, Xu C. Association between systemic immune-inflammatory markers and monoclonal gammopathy of undetermined significance in the elderly population: findings from the National Health and Nutrition Examination Survey. Clin Exp Med. 2026;26(1): 107. doi:10.1007/s10238-025-02022-1
11. Li N, Huang J, Xie Y, et al. The prognostic value of hemoglobin, albumin, lymphocyte, and platelet (HALP) score in low-risk and early-stage extranodal natural killer/T cell lymphoma. Ann Hematol. 2025; 104(8):4133-4140. doi:10.1007/s00277-025-06272-7
12. Zhai B, Chen J, Wu J, et al. Predictive value of the hemoglobin, albumin, lymphocyte, and platelet (HALP) score and lymphocyte-to-monocyte ratio (LMR) in patients with non-small cell lung cancer after radical lung cancer surgery. Ann Transl Med. 2021;9(12):976. doi:10.21037/atm-21-2120
13. Luo M, Qin L, Li Y, et al. Inflammatory markers from routine blood tests predict survival in multiple myeloma: a systematic review and meta-analysis. Front Immunol. 2025;16:1669878. doi:10.3389/fimmu.2025.1669878
14. Ucar MA, Tombak A, Akdeniz A, et al. Immune and inflammation markers as a predictor of overall survival in patients with hematologic malignancies: a retrospective cohort study. Medicina (Kaunas). 2025; 61(6):1019. doi:10.3390/medicina61061019
15. Tomcová Z, Obertová J, Chovanec M, et al. Prognostic value of hemoglobin, albumin, lymphocyte, platelet (HALP) score in patients with metastatic renal cell carcinoma treated with nivolumab. Biomedicines. 2025;13(2):484. doi:10.3390/biomedicines13020484
16. Bati IB, Tuysuz U, Eygi E. Prognostic significance of hemoglobin, albumin, lymphocyte, and platelet (HALP) score in liver transplantation for hepatocellular carcinoma. Curr Oncol. 2025;32(8):464. doi:10.3390/curroncol32080464
17. Öztop H, Hunutlu FÇ, Ekizoğlu SI, et al. Effect of hemoglobin, albumin, lymphocyte count, and platelet (HALP) score on survival of patients with metastatic thyroid cancer treated with tyrosine kinase inhibitors. J Clin Med. 2025;14(4):1306. doi:10.3390/jcm14041306
18. Vlatka P, Marko L, Stefan M, Dorian L. The hemoglobin, albumin, lymphocyte, and platelet (HALP) score is a novel prognostic factor for patients with diffuse large B-cell lymphoma. J Cancer Res Ther. 2022; 18(3):725-732. doi:10.4103/jcrt.jcrt_174_21
19. Zhong JH, Huang DH, Chen ZY. Prognostic role of Systemic Immune-inflammation Index in solid tumors: a systematic review and meta-analysis. Oncotarget. 2017;8(43):75381-75388. doi:10.18632/oncotarget.18856
20. Huang Y, Gao Y, Wu Y, Lin H. Prognostic value of Systemic Immune-inflammation Index in patients with urologic cancers: a meta-analysis. Cancer Cell Int. 2020;20:499. doi:10.1186/s12935-020-01590-4
21. Kumar SK, Dispenzieri A, Lacy MQ, et al. Continued improvement in survival in multiple myeloma: changes in early mortality and outcomes in older patients. Leukemia. 2014;28(5):1122-1128. doi:10.1038/leu.2013.313
22. Shang Y, Jin Y, Liu H, et al. Evaluation of prognostic staging systems of multiple myeloma in the era of novel agents. Hematol Oncol. 2022;40(2): 212-222. doi:10.1002/hon.2955
Article available in :
Volume 4, Issue 3, 2026
Page : 74-79
https://doi.org/10.51271/JCHOR-0086
Article Information
Received : 17 Mar 2026
Accepted : 01 Haz 2026
Published : 08 Ağu 2026
Corresponding Author :

Can Özlü: Department of Hematology and Internal Medicine, Faculty of Medicine, University of Health Sciences, Kütahya, Turkiye

[email protected]
Citation : Özlü C, Yalçın C, Gönderen A, Acet A, Kaçmaz Kipergil D. Prognostic value of HALP score and Systemic Immune-inflammation Index in multiple myeloma. J Curr Hematol Oncol Res. 2026;4(3):74-79. doi:10.51271/JCHOR-0086

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