Prognostic analysis of HALP -LDH composite model in newly diagnosed diffuse large B-cell lymphoma patients

Background The hemoglobin–albumin–lymphocyte–platelet (HALP) score is a prognostic marker in several types of malignant tumors. The prognostic value of HALP -Lactate dehydrogenase (LDH) composite model in diffuse large B-cell lymphoma (DLBCL) remains unknown. Objective We aim to determine the prognostic value of the HALP +LDH composite model in DLBCL patients. Methods We retrospectively analyzed their clinical data and laboratory parameters from 112 newly diagnosed DLBCL patients treated with R-CHOP regimens at Zhejiang Provincial People’s Hospital from January 2014 to October 2021. According to HALP score, these patients were divided into a high-HALP group (HALP score>24.92, n=65) and a low-HALP group (HALP score ≤ 24.92, n=47). We evaluated the significance of baseline HALP +LDH composite model as a predictor of response to treatment, overall survival (OS), progression-free survival (PFS) and clinicopathological characteristics. The risk score formula was generated based on the regression coefficients of model. Results The median follow-up duration for the entire cohort was 36 months. DLBCL patients with a low HALP score (≤24.92) exhibit significantly adverse clinical and biological features, including advanced Ann Arbor stage (III–IV), elevated International Prognostic Index (IPI) score (3–5), LDH ≥250U/L, and ≥2 extranodal sites of involvement (all P < 0.05). A low HALP score (≤24.92) effectively identifies high-risk DLBCL patients and serves as an independent predictor of poor OS and PFS beyond other clinical characteristic, IPI. Additional independent predictors identified in the Cox regression analysis included advanced Ann Arbor stage III–IV, poor performance status (ECOG score ≥2), IPI score 3–5, LDH ≥250U/L and HALP (≤24.92). Furthermore, two combined models (HALP + LDH and HALP + IPI) significantly improves the assessment of patient prognosis (AUC = 0.717), superior to the individual predictive value of HALP score, LDH, or IPI alone. Conclusion The HALP+LDH composite model enhances prognostic accuracy in DLBCL and complements conventional scoring systems.