We examined the relationship between blood volume, mean haemoglobin maintained and transfusion requirement in an extensive series (166 cases) of uniformly treated patients with homozygous β-thalassaemia. The blood volume is increased in all the subjects and this increase appears inversely proportional to the mean haemoglobin level maintained. When this is above 12g/dl, the blood volume is nearly normal. The transfusion requirement of patients kept between 10 and 14 g/dl is constant. Maintenance of a high haemoglobin level in thalassaemic patients inhibits erythropoiesis to a considerable degree with a reduction of the haemopoietic tissue and hence of the total blood volume.

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