Ineffective Erythropoiesis: Anemia and Iron Overload

Hematol Oncol Clin North Am. 2018 Apr;32(2):213-221. doi: 10.1016/j.hoc.2017.11.009. Epub 2017 Dec 29.


Stress erythropoiesis (SE) is characterized by an imbalance in erythroid proliferation and differentiation under increased demands of erythrocyte generation and tissue oxygenation. β-thalassemia represents a chronic state of SE, called ineffective erythropoiesis (IE), exhibiting an expansion of erythroid-progenitor pool and deposition of alpha chains on erythrocyte membranes, causing cell death and anemia. Concurrently, there is a decrease in hepcidin expression and a subsequent state of iron overload. There are substantial investigative efforts to target increased iron absorption under IE. There are also avenues for targeting cell contact and signaling within erythroblastic islands under SE, for therapeutic benefits.

Keywords: Erythroblastic island; Hepcidin and iron homeostasis; Iron overload; Stress and ineffective erythropoiesis.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Anemia / blood
  • Anemia / etiology*
  • Anemia / metabolism*
  • Anemia / therapy
  • Animals
  • Biomarkers
  • Cell Differentiation
  • Erythroid Precursor Cells / cytology
  • Erythroid Precursor Cells / metabolism
  • Erythropoiesis* / genetics
  • Gene Expression Regulation
  • Humans
  • Iron Overload / etiology*
  • Iron Overload / metabolism*
  • Iron Overload / therapy
  • Signal Transduction
  • Stress, Physiological


  • Biomarkers