We have studied 31 -thalassaemia intermedia, 30 -thalassaemia major patients and 50 normal individuals from Turkey, determining the relationship between the nucleotide variations in -globin gene cluster, the altered levels of foetal haemoglobin and the relative ratios of -and γ mRNAs. We have found in -thalassaemia intermedia patients with high foetal haemoglobin expression that the three nucleotide variations in the 5' sequences of the gamma globin genes, A→G at Gγ -1396, the T→C at Aγ -228, and the GA→AG at Aγ -603/4, are linked to haplotype II in haplotypic homozygotes and the (AT) 8 N 14 (AT) 7 motif in LCR. Conversely, the three single nucleotide substitutions in the 5' sequences of gamma globin genes, the G→A at Gγ -1225, the A→G at Aγ + 25 and the C→G at Aγ -369, which have a strong linkage with haplotype I, V or VI in haplotypic homozygotes and the (AT) 10 N 12 (AT) 12 and the (AT) 9 N 12 (AT) 12 motifs in HS-2 of LCR are all associated with low foetal haemoglobin levels. The number of nucleotide changes in -globin gene cluster implied in our study are not the primary cause of the differences in haemoglobin F levels. They perhaps may contribute to the variations in the clinical severity observed among thalassaemia intermedia and major patients with other yet unknown gene conversions.