Difference between revisions of "Light-chain (AL) amyloidosis - historical"
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Warner-admin (talk | contribs) m (Text replacement - "'''dosing details in manuscript have been reviewed'''" to "'''dosing details in manuscript have been reviewed by our editors'''") |
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− | The purpose of this page is to provide references to regimens that are obsolete, outdated, or of historical interest only | + | <span id="BackToTop"></span> |
− | + | <div class="noprint" style="background-color:LightGray; position:fixed; bottom:2%; right:0.25%; padding-left:5px; padding-right:5px; margin: 15px; opacity:0.8; border-style: solid; border-color:DarkGray; border-width: 1px"> | |
+ | [[#top|Back to Top]] | ||
+ | </div> | ||
+ | The purpose of this page is to provide references to regimens that are obsolete, outdated, or of historical interest only. 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. | ||
{| class="wikitable" style="float:right; margin-right: 5px;" | {| class="wikitable" style="float:right; margin-right: 5px;" | ||
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<div style="background-color: #deebf6; border: 1px solid #808000; padding: 5px; {{border-radius|16px}}"><font size="4"><b>{{#ask: [[-Has subobject::{{FULLPAGENAME}}]] |?Variant |limit=10000|format=sum}} [[Tutorial#Variants|variants]] on this page</b></font></div> | <div style="background-color: #deebf6; border: 1px solid #808000; padding: 5px; {{border-radius|16px}}"><font size="4"><b>{{#ask: [[-Has subobject::{{FULLPAGENAME}}]] |?Variant |limit=10000|format=sum}} [[Tutorial#Variants|variants]] on this page</b></font></div> | ||
|} | |} | ||
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{{TOC limit|limit=3}} | {{TOC limit|limit=3}} | ||
=First-line therapy (including transplant ineligible)= | =First-line therapy (including transplant ineligible)= | ||
==Colchicine monotherapy {{#subobject:06983b|Regimen=1}}== | ==Colchicine monotherapy {{#subobject:06983b|Regimen=1}}== | ||
− | + | <div class="toccolours" style="background-color:#ee6b6e"> | |
− | |||
− | |||
− | |||
===Regimen {{#subobject:9ee4f6|Variant=1}}=== | ===Regimen {{#subobject:9ee4f6|Variant=1}}=== | ||
{| class="wikitable sortable" style="width: 100%; text-align:center;" | {| class="wikitable sortable" style="width: 100%; text-align:center;" | ||
!style="width: 20%"|Study | !style="width: 20%"|Study | ||
− | !style="width: 20%"| | + | !style="width: 20%"|Dates of enrollment |
!style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]] | !style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]] | ||
!style="width: 20%"|Comparator | !style="width: 20%"|Comparator | ||
!style="width: 20%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]] | !style="width: 20%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]] | ||
|- | |- | ||
− | |[ | + | |[https://doi.org/10.1016/0002-9343(85)90521-2 Kyle et al. 1985] |
− | | | + | |Not reported |
| 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]] | ||
− | | style="background-color:#ffffbf" | | + | | style="background-color:#ffffbf" |Did not meet primary endpoint of OS |
|- | |- | ||
− | |[https://www.amjmed.com/article/0002-9343(87)90222-1 | + | |[https://www.amjmed.com/article/0002-9343(87)90222-1 Cohen et al. 1987] |
|1976-1983 | |1976-1983 | ||
| style="background-color:#91cf61" |Non-randomized | | style="background-color:#91cf61" |Non-randomized | ||
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| style="background-color:#d3d3d3" | | | style="background-color:#d3d3d3" | | ||
|- | |- | ||
− | | rowspan="2" |[https:// | + | | rowspan="2" |[https://doi.org/10.1056/NEJM199704243361702 Kyle et al. 1997] |
|rowspan=2|1982-1992 | |rowspan=2|1982-1992 | ||
| rowspan="2" style="background-color:#1a9851" |Phase 3 (C) | | rowspan="2" style="background-color:#1a9851" |Phase 3 (C) | ||
Line 40: | Line 39: | ||
| style="background-color:#d73027" |Inferior OS | | style="background-color:#d73027" |Inferior OS | ||
|- | |- | ||
− | |2. Melphalan, Prednisone, Colchicine | + | |2. [[#MP_.26_Colchicine_888|Melphalan, Prednisone, Colchicine]] |
| style="background-color:#d73027" |Inferior OS | | style="background-color:#d73027" |Inferior OS | ||
|- | |- | ||
|} | |} | ||
− | + | <div class="toccolours" style="background-color:#b3e2cd"> | |
====Chemotherapy==== | ====Chemotherapy==== | ||
− | *[[Colchicine (Colcrys)]] | + | *[[Colchicine (Colcrys)]] 0.6 mg PO twice per day |
− | + | '''Continued indefinitely''' | |
+ | </div></div> | ||
===References=== | ===References=== | ||
− | # 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. [ | + | # 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. [https://doi.org/10.1016/0002-9343(85)90521-2 link to original article] [https://pubmed.ncbi.nlm.nih.gov/3934968/ PubMed] |
− | # 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. [https://www.amjmed.com/article/0002-9343(87)90222-1 | + | # 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. [https://www.amjmed.com/article/0002-9343(87)90222-1 link to original article] [https://pubmed.ncbi.nlm.nih.gov/3605135/ PubMed] |
− | # 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. [https:// | + | # 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. [https://doi.org/10.1056/NEJM199704243361702 link to original article] '''dosing details in manuscript have been reviewed by our editors''' [https://pubmed.ncbi.nlm.nih.gov/9110907/ PubMed] |
==Melphalan & Prednisone (MP) {{#subobject:946da1|Regimen=1}}== | ==Melphalan & Prednisone (MP) {{#subobject:946da1|Regimen=1}}== | ||
− | |||
− | |||
− | |||
− | |||
MP: '''<u>M</u>'''elphalan & '''<u>P</u>'''rednisone | MP: '''<u>M</u>'''elphalan & '''<u>P</u>'''rednisone | ||
+ | <div class="toccolours" style="background-color:#ee6b6e"> | ||
===Regimen {{#subobject:b1471a|Variant=1}}=== | ===Regimen {{#subobject:b1471a|Variant=1}}=== | ||
{| class="wikitable sortable" style="width: 100%; text-align:center;" | {| class="wikitable sortable" style="width: 100%; text-align:center;" | ||
!style="width: 20%"|Study | !style="width: 20%"|Study | ||
− | !style="width: 20%"| | + | !style="width: 20%"|Dates of enrollment |
!style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]] | !style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]] | ||
!style="width: 20%"|Comparator | !style="width: 20%"|Comparator | ||
!style="width: 20%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]] | !style="width: 20%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]] | ||
|- | |- | ||
− | |[ | + | |[https://doi.org/10.1182/blood.V52.4.818.818 Kyle et al. 1978] |
− | | | + | |Not reported |
| style="background-color:#1a9851" |Randomized (E-esc) | | style="background-color:#1a9851" |Randomized (E-esc) | ||
|[[Light-chain_(AL)_amyloidosis_-_null_regimens#Placebo|Placebo]] | |[[Light-chain_(AL)_amyloidosis_-_null_regimens#Placebo|Placebo]] | ||
| style="background-color:#91cf60" |Longer time on treatment | | style="background-color:#91cf60" |Longer time on treatment | ||
|- | |- | ||
− | |[ | + | |[https://doi.org/10.1016/0002-9343(85)90521-2 Kyle et al. 1985] |
− | | | + | |Not reported |
| style="background-color:#1a9851" |Randomized (E-switch-ooc) | | style="background-color:#1a9851" |Randomized (E-switch-ooc) | ||
|[[#Colchicine_monotherapy|Colchicine]] | |[[#Colchicine_monotherapy|Colchicine]] | ||
− | | style="background-color:#ffffbf" | | + | | style="background-color:#ffffbf" |Did not meet primary endpoint of OS |
|- | |- | ||
− | | rowspan="2" |[https:// | + | | rowspan="2" |[https://doi.org/10.1056/NEJM199704243361702 Kyle et al. 1997] |
|rowspan=2|1982-1992 | |rowspan=2|1982-1992 | ||
| rowspan="2" style="background-color:#1a9851" |Phase 3 (C) | | rowspan="2" style="background-color:#1a9851" |Phase 3 (C) | ||
Line 85: | Line 82: | ||
| style="background-color:#1a9850" |Superior OS | | style="background-color:#1a9850" |Superior OS | ||
|- | |- | ||
− | |2. Melphalan, Prednisone, Colchicine | + | |2. [[#MP_.26_Colchicine_999|Melphalan, Prednisone, Colchicine]] |
− | | style="background-color:#ffffbf" | | + | | style="background-color:#ffffbf" |Did not meet primary endpoint of OS |
|- | |- | ||
|} | |} | ||
− | '' | + | ''Note: some studied divided the doses of melphalan and prednisone; others did not; see individual papers for details.'' |
+ | <div class="toccolours" style="background-color:#b3e2cd"> | ||
====Chemotherapy==== | ====Chemotherapy==== | ||
− | *[[Melphalan (Alkeran)]] | + | *[[Melphalan (Alkeran)]] 0.15 mg/kg/day PO on days 1 to 7 |
− | *[[Prednisone (Sterapred)]] | + | ====Glucocorticoid therapy==== |
− | + | *[[Prednisone (Sterapred)]] 0.8 mg/kg/day PO on days 1 to 7 | |
+ | '''42-day cycles''' | ||
+ | </div></div> | ||
===References=== | ===References=== | ||
− | # Kyle RA, Greipp PR. Primary systemic amyloidosis: comparison of melphalan and prednisone versus placebo. Blood. 1978 Oct;52(4):818-27. [ | + | # Kyle RA, Greipp PR. Primary systemic amyloidosis: comparison of melphalan and prednisone versus placebo. Blood. 1978 Oct;52(4):818-27. [https://doi.org/10.1182/blood.V52.4.818.818 link to original article] '''dosing details in manuscript have been reviewed by our editors''' [https://pubmed.ncbi.nlm.nih.gov/356916/ PubMed] |
− | # 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. [ | + | # 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. [https://doi.org/10.1016/0002-9343(85)90521-2 link to original article] '''dosing details in manuscript have been reviewed by our editors''' [https://pubmed.ncbi.nlm.nih.gov/3934968/ PubMed] |
− | # 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. [https:// | + | # 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. [https://doi.org/10.1056/NEJM199704243361702 link to original article] '''dosing details in manuscript have been reviewed by our editors''' [https://pubmed.ncbi.nlm.nih.gov/9110907/ PubMed] |
− | |||
[[Category:Light-chain (AL) amyloidosis regimens]] | [[Category:Light-chain (AL) amyloidosis regimens]] | ||
[[Category:Disease-specific pages]] | [[Category:Disease-specific pages]] | ||
[[Category:Plasma cell dyscrasias]] | [[Category:Plasma cell dyscrasias]] | ||
[[Category:Historical regimens]] | [[Category:Historical regimens]] |
Latest revision as of 12:20, 15 July 2024
The purpose of this page is to provide references to regimens that are obsolete, outdated, or of historical interest only. 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 | Not reported | 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 |
References
- 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
- 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
- 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 dosing details in manuscript have been reviewed by our editors PubMed
Melphalan & Prednisone (MP)
MP: Melphalan & Prednisone
Regimen
Study | Dates of enrollment | Evidence | Comparator | Comparative Efficacy |
---|---|---|---|---|
Kyle et al. 1978 | Not reported | Randomized (E-esc) | Placebo | Longer time on treatment |
Kyle et al. 1985 | Not reported | 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 |
Note: some studied divided the doses of melphalan and prednisone; others did not; see individual papers for details.
Chemotherapy
- Melphalan (Alkeran) 0.15 mg/kg/day PO on days 1 to 7
Glucocorticoid therapy
- Prednisone (Sterapred) 0.8 mg/kg/day PO on days 1 to 7
42-day cycles
References
- 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 dosing details in manuscript have been reviewed by our editors PubMed
- 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 dosing details in manuscript have been reviewed by our editors PubMed
- 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 dosing details in manuscript have been reviewed by our editors PubMed