The term β-thalassemia intermedia (β-TITI) is a term that describes patients witha form ofmilder anemia than patients with β-thalassemia major. Ineffective erythropoiesis, chronic
hemolytic anemia, and iron overload are the main factors responsible for prognosis thedisease process in patients with β-TI. Chronic hemolytic anemia may have such adverse
effects asresult in increased in gastrointestinal iron absorption and iron overload, which inturn can cause endocrine abnormalities, diabetes mellitus, osteoporosis, hypothyroidism, andhypogonadism. The options available for managing patients with β-TI include Iron ironchelation therapy, splenectomy, transfusion therapy, and modulation of fetal hemoglobin(HbF) production are several available options for managing patients with β-TI.
Pharmacological agents that increase γ-globin production [e.g., like Hydroxyurea
hydroxyurea (HU), )], as evidenced by an increased in HbF levels, have been considered astherapeutic agents for patients with β-thalassemiaTI. Increaseding the synthesis of fetal
hemoglobinHbF synthesis can help reduce anemia and, thereby, improve improving theclinical condition of these patients of patients with β-TI. In several patients with β-TI and in

Comment [A1]: Once an abbreviation isintroduced in the text, the abbreviated form is usedconsistently at all subsequent mentions.

patients with sickle-cell disease, a riseIncreases in total HbF levels during HU treatment has
have been repeatedly reported during HU treatment in several patients with β-TI and in thosewith sickle-cell disease. HU treatment can reduce blood transfusion dependency and evenmake some patients transfusion free, increasing their energy state level and decreasing
splenomegaly. HU treatmentIt also is protectiveprotects for against hypothyroidism,
pulmonary hypertension, extramedullary hematopoiesis, leg ulcers, and osteoporosis. The
commonest most common side effects of HU therapy treatment include neutropenia andthrombocytopenia, ; both of which these are predictable and can be easily
manageablemanaged. In the few studies conducted on the side effects of HU treatment in βTI patients with β-TI, dermatological, neurological, and gastrointestinal adverse effects were
have been seen observed without any reports of endocrine abnormality, bone marrow
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Comment [A2]: The pronoun “it” is used at thisinstance to avoid repeating the term “HU treatment”
as the previous statement also pertains to HUtreatment.
Comment [A3]: In academic writing, it ispreferable to use consistent terminology so thatconcepts are clearly understood. The term “HUtherapy” has been revised to “HU treatment” forconsistency.

suppression, or hematological toxicity. In the present study,We aimed to perform medium- tolong-term follow-up of chronic low-dose HU treatment was inspected to for analyze
analyzing the its effect of HU treatment on the thyroid function of patients with β-TI.

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Comment [A4]: Compound adjectives thatmodify a single noun are typically hyphenated,
except when the first word of the adjective is anadverb ending with “-ly.” Hyphens are used withthese terms so that their meaning is understoodclearly.