The clinical phenotype of thalassaemia intermedia (TI) lies between those of thalassaemia minor and major, although a clinical overlap between the three conditions is also possible. TI was first described in 1955 by Rietti-Greppi-Micheli, who explained that those patients are `too haematologically severe to be called minor, but too mild to be called major`. TI has a wide clinical spectrum. Some of the patients could be completely asymptomatic until adult life, manifesting only mild anaemia and managing to maintain haemoglobin (Hb) levels between 7-10 g/dL. At some point they could require only occasional blood transfusions. The more severe cases of TI usually present between 2 and 6 years. They are also able to survive without regular transfusion therapy, but the growth and development of those children would be delayed. The broad clinical spectrum of TI requires an individualised treatment approach to those patients. Regardless of the fact that multiple treatment options are possible, the treatment of TI is still a challenging task for every haematologist.
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