Individuals with homozygous Hb D-Punjab were typically asymptomatic with normal hematological characteristics (el-Kalla and Mathews, 1997; Silva-Pinto et al., 2014), although a few of them developed mild to moderate anemia and led to pallor and fatigability (Singh et al., 2023; Spandana et al., 2022). The gene discussed is GSTM1; the disease is anemia.