John H. Mason

Survival of patients with primary (AL) amyloidosis: Colchicine-treated cases from 1976 to 1983 compared with cases seen in previous years (1961 to 1973)☆

Primary amyloidosis has a variable course, but is generally associated with a short life expectancy. To date, no specific therapy has been available. Fifty-three patients with AL amyloidosis seen between 1976 and 1983 were treated with colchicine, and their clinical course and survival were compared with that in 29 other patients seen between 1961 and 1973. Of the variables measured, the treatment, the patients sex, and the time interval from diagnosis to referral of treatment were significantly associated with length of survival. Median survival for the colchicine-treated patients was 17 months, compared with six months for the non-colchicine-treated patients. A surprising finding was the longer life span in female patients (median eight months versus four and a half months in the non-colchicine-treated group, and 25.5 months versus 10 month in the colchicine-treated group). The study suggests that colchicine has improved the life expectancy in AL amyloidosis. Although it is not a specific therapy, it may be a reasonable form of adjunctive treatment in this complex disorder.

The Life Span of Patients with Primary (AL) Amyloidosis and the Effect of Colchicine Treatment

There is no specific treatment for any variety of amyloidosis [1]. Primary (AL) amyloidosis, now the more commonly seen form of the disorder, usually has a poor prognosis and short life expectancy [2]. Colchicine, which effectively prevents acute fibril attacks in patients with familial Mediterranean fever (FMF), a condition that predisposes to amyloidosis, has been shown to block amyloid production in the mouse model [3,4]. In addition, reports indicate that patients with FMF receiving colchicine no longer develop amyloidosis and suggest improvement in some amyloidotic patients with this form of AA amyloid [5, 6].