Which of the following disorders is associated with ineffective erythropoiesis?

Ineffective erythropoiesis refers to a condition in which insufficient healthy red blood cells are produced, typically due to issues with red blood cell development in the bone marrow. Megaloblastic anemia, specifically, arises from impaired DNA synthesis, usually due to vitamin B12 or folate deficiency. This leads to the production of large, immature red blood cells (megaloblasts) that are not effectively released into the bloodstream, resulting in anemia.

In megaloblastic anemia, the defective formation of red blood cells and their precursors ultimately causes a decrease in the number of functional red blood cells available to carry oxygen, leading to clinical symptoms of anemia. The specific problem with cellular development in megaloblastic anemia exemplifies ineffective erythropoiesis, providing a clear connection to the disorder described in the question.

In contrast, the other conditions mentioned do not primarily involve ineffective erythropoiesis. G6PD deficiency relates to hemolysis rather than production issues, liver disease may cause anemia but typically involves complex mechanisms beyond just ineffective erythropoiesis, and Hgb C disease, while leading to some ineffective functioning of red blood cells, mainly results in hemolysis rather than the production failure central to