The recent report on “disease severity scoring system for non-transfusion-dependent thalassemia (NTDT)” is very interesting . Cappellini et al. proposed for a new system and concluded that “this new disease severity scoring system for adult and pediatric NTDT patients could be developed into a practical tool for widespread clinical use .” The proposed scoring system is very interesting. However, there are some concerns on the present score. The generalization of this score for different settings should be discussed.