Refers to the inability to produce adequate number of red blood cells in the presence of increased immature erythroid precursors.
Per Cazzola, M.:
- In ineffective erythropoiesis, the erythroid marrow is active and expanded (erythroid hyperplasia) but its efficacy in terms of red cell production is impaired and may lead to anemia.
- Erythroblasts are predominant in the bone marrow, and the M/E ratio is <1:1.
- Ineffective erythropoiesis is a major pathogenetic mechanism that is responsible for anemia in several inherited and acquired disorders, including:
- Transfusion-dependent β-thalassemia (also known as β-thalassemia major)
- Nontransfusion-dependent β-thalassemia (also known as β-thalassemia intermedia; including β-thalassemia/Hb E)
- Inherited sideroblastic anemias
- Congenital dyserythropoietic anemias
- Megaloblastic anemias
- Myelodysplastic syndrome
- Patients with ineffective erythropoiesis may have evidence of parenchymal iron overload, which derives from suppression of hepcidin production.