EPO and anemia: This possible reason could be due to directly or indirectly exacerbating anemia either by suppressing hematopoiesis through bone marrow infiltration or production of cytokines that lead to iron sequestration, inhibit release and synthesis of endogenous erythropoietin, reduce the response of erythroid progenitor cells to erythropoietin, which ultimately impair erythropoiesis.