Which statement best describes thalassemia major in terms of onset?

• A. Usually presents with symptoms during the first two years of life
• B. Is asymptomatic
• C. Doesn't involve the blood
• D. Only affects adults

Answer: (A)

Thalassemia major is a severe hemoglobin disorder where defective beta-globin production leads to significant anemia as fetal hemoglobin (which is protective) declines after birth. Because HbF is high in early infancy, symptoms often don’t appear until later in the first year, and most children with thalassemia major become symptomatic within the first two years of life. This timing explains why the statement describing onset in the first two years best fits the condition. It isn’t asymptomatic, it clearly involves blood (hemoglobin and red blood cell production), and it does not primarily affect adults—the onset is early childhood, not in later life.