Utilization of HALP and Systemic Immune-Inflammation Index for Thrombotic Risk in Polycythemia Vera and Essential Thrombocythemia

AIM: Thrombotic complications are a primary source of morbidity for patients with Polycythemia Vera (PV) and Essential Thrombocythemia (ET). The present study was designed to evaluate the clinical utility of the systemic immune-inflammation index (SII) and the HALP score—a composite of hemoglobin, albumin, lymphocytes, and platelets—in predicting the risk of thrombosis within this population.
MATRERIAL and METHOD: This retrospective study included adult patients diagnosed with PV or ET between 2015 and 2024. Demographic, clinical, genetic, and laboratory data were obtained from hospital records. HALP and SII scores were calculated using laboratory parameters. Patients were categorized according to the presence or absence of thrombosis, and comparative statistical analyses were performed. The discriminatory performance of SII and HALP for thrombotic risk was evaluated using ROC curve analysis.
RESULTS: The study included 93 patients (mean age, 62.1 ± 14.6 years; 63.4% male). PV constituted 80.6% of diagnoses. Thrombotic events occurred in 27 patients (29%). Neutrophil counts were higher in the thrombosis group (8.8 ± 3.3 vs. 7.4 ± 3.5 ×10⁹/L, p = 0.008), while lymphocyte counts were lower (2.1 ± 0.7 ×10⁹/L vs 2.5 ± 0.8, p = 0.042). HALP scores were markedly lower among individuals with thrombosis (37.5 ± 18.7 vs. 52.9 ± 25.4, p < 0.001). SII did not show a significant difference (p = 0.084). ROC analysis revealed that HALP had acceptable predictive accuracy (AUC = 0.723), with a cutoff of 32.2 yielding 70.6% sensitivity and 59.4% specificity. Overall, HALP was superior to SII for predicting thrombosis.
CONCLUSION: The HALP score appears to be a practical and informative biomarker for identifying PV and ET patients at elevated thrombotic risk.