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: Thalassemia: 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.