Light-chain (AL) amyloidosis - null regimens

The purpose of this page is to provide references to "null therapy" such as placebo and observation. These references provide further insight into the historical development of the treatment landscape. See the main light-chain (AL) amyloidosis page for regimens that include active anticancer treatment.

First-line therapy (including transplant ineligible)

No induction

Regimen

Study	Dates of enrollment	Evidence	Comparator	Comparative Efficacy
Huang et al. 2014 (NJCT-0703)	2009-2012	Randomized Phase 2 (C)	BD	Seems to have inferior OS

No induction prior to transplant.

Subsequent treatment

• High-dose melphalan with autologous hematopoietic stem cell transplant consolidation

References

1. NJCT-0703: Huang X, Wang Q, Chen W, Zeng C, Chen Z, Gong D, Zhang H, Liu Z. Induction therapy with bortezomib and dexamethasone followed by autologous stem cell transplantation versus autologous stem cell transplantation alone in the treatment of renal AL amyloidosis: a randomized controlled trial. BMC Med. 2014 Jan 6;12:2. link to original article link to PMC article PubMed NCT01998503

Placebo

Regimen

Study	Dates of enrollment	Evidence	Comparator	Comparative Efficacy
Kyle et al. 1978	NR	Randomized (C)	MP	Shorter time on treatment

No active antineoplastic treatment.

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