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The purpose of this page is to provide references to regimens that are obsolete, outdated, or of historical interest only.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


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

Chemotherapy

Continued indefinitely

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 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

Glucocorticoid therapy

42-day cycles

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 dosing details in manuscript have been reviewed by our editors 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 dosing details in manuscript have been reviewed by our editors 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 dosing details in manuscript have been reviewed by our editors PubMed