Difference between revisions of "Light-chain (AL) amyloidosis - historical"

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The purpose of this page is to provide references to regimens that are obsolete, outdated, or of historical interest only. As a general rule, this includes the inferior arm(s) of a randomized study, unless said regimens continue to be recommended by trustworthy sources such as the [http://www.nccn.org/professionals/physician_gls/f_guidelines.asp NCCN Guidelines]. Is there a regimen missing from this list? Please go to the [[Light-chain (AL) amyloidosis|main light-chain (AL) amyloidosis regimen page]] to find other regimens.
 
The purpose of this page is to provide references to regimens that are obsolete, outdated, or of historical interest only. As a general rule, this includes the inferior arm(s) of a randomized study, unless said regimens continue to be recommended by trustworthy sources such as the [http://www.nccn.org/professionals/physician_gls/f_guidelines.asp NCCN Guidelines]. Is there a regimen missing from this list? Please go to the [[Light-chain (AL) amyloidosis|main light-chain (AL) amyloidosis regimen page]] to find other regimens.
 
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| style="background-color:#1a9851" |Randomized (E-switch-ooc)
 
| style="background-color:#1a9851" |Randomized (E-switch-ooc)
 
|[[#Melphalan_.26_Prednisone_.28MP.29|MP]]
 
|[[#Melphalan_.26_Prednisone_.28MP.29|MP]]
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| style="background-color:#ffffbf" |Seems not superior
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| style="background-color:#ffffbf" |Did not meet primary endpoint of OS
 
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|[https://www.amjmed.com/article/0002-9343(87)90222-1 Cohen et al. 1987]
 
|[https://www.amjmed.com/article/0002-9343(87)90222-1 Cohen et al. 1987]
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| style="background-color:#1a9851" |Randomized (E-switch-ooc)
 
| style="background-color:#1a9851" |Randomized (E-switch-ooc)
 
|[[#Colchicine_monotherapy|Colchicine]]
 
|[[#Colchicine_monotherapy|Colchicine]]
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| style="background-color:#ffffbf" |Seems not superior
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| style="background-color:#ffffbf" |Did not meet primary endpoint of OS
 
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| rowspan="2" |[https://doi.org/10.1056/NEJM199704243361702 Kyle et al. 1997]
 
| rowspan="2" |[https://doi.org/10.1056/NEJM199704243361702 Kyle et al. 1997]
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|2. [[#MP_.26_Colchicine_999|Melphalan, Prednisone, Colchicine]]
 
|2. [[#MP_.26_Colchicine_999|Melphalan, Prednisone, Colchicine]]
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| style="background-color:#ffffbf" |Seems not superior
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| style="background-color:#ffffbf" |Did not meet primary endpoint of OS
 
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Revision as of 13:18, 13 August 2023

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The purpose of this page is to provide references to regimens that are obsolete, outdated, or of historical interest only. As a general rule, this includes the inferior arm(s) of a randomized study, unless said regimens continue to be recommended by trustworthy sources such as the NCCN Guidelines. Is there a regimen missing from this list? Please go to the main light-chain (AL) amyloidosis regimen page to find other regimens.

2 regimens on this page
2 variants on this page


First-line therapy (including transplant ineligible)

Colchicine monotherapy

Regimen

Study Dates of enrollment Evidence Comparator Comparative Efficacy
Kyle et al. 1985 NR Randomized (E-switch-ooc) MP Did not meet primary endpoint of OS
Cohen et al. 1987 1976-1983 Non-randomized
Kyle et al. 1997 1982-1992 Phase 3 (C) 1. MP Inferior OS
2. Melphalan, Prednisone, Colchicine Inferior OS

Chemotherapy

References

  1. Kyle RA, Greipp PR, Garton JP, Gertz MA. Primary systemic amyloidosis: comparison of melphalan/prednisone versus colchicine. Am J Med. 1985 Dec;79(6):708-16. link to original article PubMed
  2. Cohen AS, Rubinow A, Anderson JJ, Skinner M, Mason JH, Libbey C, Kayne H. Survival of patients with primary (AL) amyloidosis: colchicine-treated cases from 1976 to 1983 compared with cases seen in previous years (1961 to 1973). Am J Med. 1987 Jun;82(6):1182-90. link to original article PubMed
  3. Kyle RA, Gertz MA, Greipp PR, Witzig TE, Lust JA, Lacy MQ, Therneau TM. A trial of three regimens for primary amyloidosis: colchicine alone, melphalan and prednisone, and melphalan, prednisone, and colchicine. N Engl J Med. 1997 Apr 24;336(17):1202-7. link to original article PubMed

Melphalan & Prednisone (MP)

MP: Melphalan & Prednisone

Regimen

Study Dates of enrollment Evidence Comparator Comparative Efficacy
Kyle et al. 1978 NR Randomized (E-esc) Placebo Longer time on treatment
Kyle et al. 1985 NR Randomized (E-switch-ooc) Colchicine Did not meet primary endpoint of OS
Kyle et al. 1997 1982-1992 Phase 3 (C) 1. Colchicine Superior OS
2. Melphalan, Prednisone, Colchicine Did not meet primary endpoint of OS

Chemotherapy

Glucocorticoid therapy

References

  1. Kyle RA, Greipp PR. Primary systemic amyloidosis: comparison of melphalan and prednisone versus placebo. Blood. 1978 Oct;52(4):818-27. link to original article PubMed
  2. Kyle RA, Greipp PR, Garton JP, Gertz MA. Primary systemic amyloidosis: comparison of melphalan/prednisone versus colchicine. Am J Med. 1985 Dec;79(6):708-16. link to original article PubMed
  3. Kyle RA, Gertz MA, Greipp PR, Witzig TE, Lust JA, Lacy MQ, Therneau TM. A trial of three regimens for primary amyloidosis: colchicine alone, melphalan and prednisone, and melphalan, prednisone, and colchicine. N Engl J Med. 1997 Apr 24;336(17):1202-7. link to original article PubMed
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