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The purpose of this page is to provide references to regimens that are obsolete, outdated, or of historical interest only.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 	Shorter OS
Kyle et al. 1997 	1982-1992 	Phase 3 (C) 	2. Melphalan, Prednisone, Colchicine	Shorter OS
====Chemotherapy====
*Colchicine (Colcrys) 0.6 mg PO twice per day
Continued indefinitely
===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 EuroPMC
# 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 EuroPMC
# 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 EuroPMC
==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 	Longer OS
Kyle et al. 1997	1982-1992 	Phase 3 (C) 	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 EuroPMC
# 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 EuroPMC
# 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 EuroPMC
Category:Light-chain (AL) amyloidosis regimens
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Category:Historical regimens