Difference between revisions of "Light-chain (AL) amyloidosis - historical"
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+ | ''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"> | <div class="toccolours" style="background-color:#b3e2cd"> | ||
====Chemotherapy==== | ====Chemotherapy==== | ||
− | *[[Melphalan (Alkeran)]] | + | *[[Melphalan (Alkeran)]] 0.15 mg/kg/day PO on days 1 to 7 |
====Glucocorticoid therapy==== | ====Glucocorticoid therapy==== | ||
− | *[[Prednisone (Sterapred)]] | + | *[[Prednisone (Sterapred)]] 0.8 mg/kg/day PO on days 1 to 7 |
+ | '''42-day cycles''' | ||
</div></div> | </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. [http://www.bloodjournal.org/content/52/4/818.long link to original article] [https://pubmed.ncbi.nlm.nih.gov/356916/ PubMed] | + | # Kyle RA, Greipp PR. Primary systemic amyloidosis: comparison of melphalan and prednisone versus placebo. Blood. 1978 Oct;52(4):818-27. [http://www.bloodjournal.org/content/52/4/818.long link to original article] '''contains dosing details in manuscript''' [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. [https://doi.org/10.1016/0002-9343(85)90521-2 link to original article] [https://pubmed.ncbi.nlm.nih.gov/3934968/ 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. [https://doi.org/10.1016/0002-9343(85)90521-2 link to original article] '''contains dosing details in manuscript''' [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://doi.org/10.1056/NEJM199704243361702 link to original article] [https://pubmed.ncbi.nlm.nih.gov/9110907/ 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://doi.org/10.1056/NEJM199704243361702 link to original article] '''contains dosing details in manuscript''' [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]] |
Revision as of 22:07, 22 December 2023
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 |
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 contains dosing details in manuscript 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 |
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 contains dosing details in manuscript 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 contains dosing details in manuscript 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 contains dosing details in manuscript PubMed