A B S T R A C T In Italian patients with high hemoglobinA2 fl-thalassemia trait, the synthesis of P-chains of adult hemoglobin in the peripheral blood is approximately one-half that of a-chains. In this study the relative rates of f-and a-chain synthesis were determined in 26 Negro heterozygotes and five homozygotes for fi-thalassemia in six families. The 8/a ratio of globin synthesis was decreased in only 15 heterozygotes, whereas in the other 11, fl/a globin synthesis was in the normal range or was slightly increased. These unusual findings did not appear to be due to the presence of a-thalassemia or a hyperactive "normal" fl-allele. This study demonstrates that the f8/a ratio of globin synthesis in the peripheral blood is normal in some patients with