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Effect of iron status on the erythropoiesis in bone marrow. In the condition of iron deficiency, TSAT and serum ferritin level are decreased, which diminishes iron supplementation for erythroid precursors. In the condition of iron overload, serum ferritin level is high but TSAT may be variable by the timing of iron administration. Bone marrow iron overload attenuates erythroid differentiation by oxidative stress in erythroid niche, which causes hyporesponsiveness to ESAs.
