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The purpose of this page is to provide references to regimens that are obsolete, outdated, or of historical interest only. Is there a regimen missing from this list? Please go to the main light-chain (AL) amyloidosis regimen page to find other regimens.
Last updated on 2024-07-23: 2 regimens on this page
2 variants on this page
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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. MP & 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