RT Journal
A1 Schwartz RS, Cohen JR, Schrier SL
T1 THerapy of primary amyloidosis with melphalan and prednisone
JF Archives of Internal Medicine
JO Archives of Internal Medicine
YR 1979
FD October 1
VO 139
IS 10
SP 1144
OP 1147
DO 10.1001/archinte.1979.03630470056018
UL http://dx.doi.org/10.1001/archinte.1979.03630470056018
AB Two patients with progressive primary amyloidosis, monoclonal serum and urinary proteins, multiple organ involvement, and nephrotic syndrome were treated with melphalan and prednisone for one year. In one patient, splenomegaly and nephrotic syndrome rapidly responded to therapy but massive hepatomegaly responded slowly, requiring 15 months' time for normalization of size. Results of liver function tests, although improved, remained abnormal, and amyloid deposits remained in the marrow. A second patient also demonstrated dramatic diminution in proteinuria and improvement in liver function abnormalities, but macroglossia persisted. These observations suggest that amyloid organ involvement may be reversible with differences in organ responsiveness to chemotherapy. An empirical trial of chemotherapy may be indicated in some patients with progressive primary amyloidosis, and therapy may need to be continued for a prolonged period of time before seeing an effect.(Arch Intern Med 139:1144-1147, 1979)