Terminal differentiation of erythroid cells can be influenced by ROS: a recent study showed that, when enzyme Isocitrate Dehydrogenase 1 (IDH1) is downregulated or knocked out, as in some IDH1 mutated AML and MDS, the oxidative stress induces the synthesis of dysplastic erythroblasts with morphological abnormalities, as double nuclei. Here, IDH1 is linked to myelodysplastic syndrome.