β-thalassemia intermedia (β-TI) is a term that describes is patients witha milder form ofanemia than patients with β-thalassemia major. Ineffective erythropoiesis, chronic hemolytic
anemia, and iron overload are the main factors responsible for the disease process prognosis
in patients with β-TI. Chronic anemia may have such adverse effects, such as increased in
gastrointestinal iron absorption and iron overload, which canin turn can cause endocrine
abnormalities, diabetes mellitus, osteoporosis, hypothyroidism, and hypogonadism. Ironchelation therapy, splenectomy, transfusion therapy, and modulation of fetal hemoglobin(HbF) production are several availablethe options available for managing patients with β-TI.
Pharmacological agents that increase γ-globin production, like such as Hydroxyurea
hydroxyurea (HU), as evidenced by an increased in HbF levels, have been considered astherapeutic agents for patients with β-thalassemiaTI. Increasing the synthesis of fetal
hemoglobinHbF can help reduce anemia and, thereby, improve the clinical condition ofpatients with β-TI. In several patients with β-TI and in patients with sickle-cell disease, aComment [A1]: Once an abbreviation is
introduced in the text, the abbreviated form is usedconsistently at all subsequent mentions.

riseIncreases in total HbF levels has have been repeatedly reported during HU treatment inseveral patients with β-TI and in patients with sickle-cell disease. HU treatment can reduce
blood transfusion dependency and even make some patients transfusion free, increasing
which in turn increases their energy state level and decreasing decreases splenomegaly. HUtreatment It also is protectiveprotects for against hypothyroidism, pulmonary hypertension,
extramedullary hematopoiesis, leg ulcers, and osteoporosis. The commonest most commonside effects of HU therapy treatment include neutropenia and thrombocytopenia, ; both ofwhich these are predictable and easily manageable. In the few studies conducted on the side

Comment [A2]: In academic writing, it ispreferable to use consistent terminology so thatconcepts are clearly understood. The term “HUtherapy” has been revised to “HU treatment” forconsistency.

effects of HU treatment in β-TI patients with β-TI, dermatological, neurological, andgastrointestinal adverse effects were seen observed without any reports of endocrine
abnormality, bone marrow suppression, or hematological toxicity. In the present study, weaimed to perform medium- to long-term follow-up of chronic low-dose HU treatment was
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Comment [A3]: 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.

inspected in order to analyze the its effect of HU treatment on the thyroid function of patientswith β-TI.

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