Sir.—The article "Deficient Activity of the Alternative Pathway of Complement in β Thalassemia Major" by Corry et al (Journal 1981;135:529-531) deals with the topic of susceptibility to infections in thalassemic children, especially after splenectomy. The deficient activity of the alternative pathway of complement observed by Corry and colleagues contributes to the study of this obscure problem. Various aspects of both humoral and cellular immunity have been investigated in thalassemia, but the results are discordant.1-6 Thus, a decrease of the capacity of host defense in these patients is not firmly established.
We present our own experience in treating patients with thalassemia. We observed significant activation of the nitroblue tetrazolium (NBT) test in patients with hemoglobin levels below 6 g/dL (27.8% ±19.7%), whereas the patients with higher levels showed normal mean values (14.9% ±10.1% v 15.5% ±8% in normal children). We noticed no effect of splenectomy on this function. Although