The recent report on “disease severity scoring system for non-transfusion-dependent thalassemia (NTDT)” is very interesting [1]. 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 [1].” 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.