This article has an addendum. Addendum in: Oncotarget. 2023; 14:748-748.

What is hemoglobin, albumin, lymphocyte, platelet (HALP) score? A comprehensive literature review of HALP’s prognostic ability in different cancer types

Christian Mark Farag _, Ryan Antar, Sinan Akosman, Matthew Ng and Michael J. Whalen

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Oncotarget. 2023; 14:153-172. https://doi.org/10.18632/oncotarget.28367

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Christian Mark Farag1, Ryan Antar1, Sinan Akosman1, Matthew Ng2 and Michael J. Whalen1

1 Department of Urology, George Washington University School of Medicine, Washington, DC 20052, USA

2 Department of Surgery, George Washington University School of Medicine, Washington, DC 20052, USA

Correspondence to:

Christian Mark Farag, email: [email protected]

Keywords: HALP score; biomarker; prognosis; cancer; survival

Received: December 25, 2022     Accepted: January 23, 2023     Published: February 25, 2023

Copyright: © 2023 Farag et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Since its inception, the Hemoglobin, Albumin, Lymphocyte, Platelet Score (HALP) has gained attention as a new prognostic biomarker to predict several clinical outcomes in a multitude of cancers. In our review, we searched PubMed for articles between the first paper on HALP in 2015 through September 2022, yielding 32 studies in total that evaluated HALP's association with various cancers, including Gastric, Colorectal, Bladder, Prostate, Kidney, Esophageal, Pharyngeal, Lung, Breast, and Cervical cancers, among others. This review highlights the collective association HALP has with demographic factors such as age and sex in addition to TNM staging, grade, and tumor size. Furthermore, this review summarizes HALP's prognostic ability to predict overall survival, progression-free survival, recurrence-free survival, among other outcomes. In some studies, HALP has also been able to predict response to immunotherapy and chemotherapy.

This review article also aims to serve as a comprehensive and encyclopedic report on the literature that has evaluated HALP as a biomarker in various cancers, highlighting the heterogeneity surrounding HALP's utilization. Because HALP requires only a complete blood count and albumin - already routinely collected for cancer patients - HALP shows potential as a cost-effective biomarker to aid clinicians in improving outcomes for immuno-nutritionally deficient patients.

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