Melphalan, prednisolone and thalidomide (MPT) and myeloma Infoguide

This Infoguide provides information about melphalan, prednisolone and thalidomide (MPT), one of the treatment combinations used in myeloma. It aims to provide you with information about MPT as a treatment combination for myeloma, answer some of the questions you may have about MPT and help you to make informed decisions about treatment options.

MPT is an oral (tablet form) treatment combination for myeloma. It is often referred to as ‘chemotherapy’
or ‘chemo’, but it is actually a combination of three different types of drugs:

  • Melphalan – a chemotherapy drug;
  • Prednisolone – a steroid;
  • Thalidomide – an immunomodulatory drug.

These three drugs have different but synergistic and complementary mechanisms of action. This means they work in different ways, but when given together they are more effective at killing myeloma cells than when they are given alone. MPT is an approved initial treatment option for older and/or less fit myeloma patients who are not eligible for high-dose therapy and stem cell transplantation (HDT-SCT).

It falls under the National Institute for Health and Care Excellence (NICE) recommendation that thalidomide is given in combination with an alkylating chemotherapy drug and steroid as an initial treatment for myeloma. Since thalidomide was approved as part of a multiple technology assessment (MTA), this recommendation is also
applicable in Scotland.