Preliminary data showed that anemia severity is associated with inadequate reticulocytosis, possibly representing an autoimmune reaction against bone marrow erythroblasts.10 Consistently, the presence of BM hypercellularity, dyserythropoiesis, and fibrosis has been reported in about 1/3 of AIHA patients, with a proinflammatory cytokine signature, particularly in relapsed/refractory ones.10 These patients show similar features to bone marrow failure syndromes, may benefit of recombinant erythropoietin, and may eventually evolve into myelodysplastic forms.10–15. This evidence concerns the gene EPO and anemia.