Normally about 1:2, the E:G ratio is decreased in acute and chronic infection, leukemoid reactions (e.g., chronic inflammation, metastatic tumor), acute and chronic myeloid leukemia, myelodysplastic disorders (“preleukemia”), and pure red cell aplasia; increased in agranulocytosis, anemias with erythroid hyperplasia (megaloblastic, iron-deficiency, thalassemia, hemorrhage, hemolysis, sideroblastic), and erythrocytosis (excessive RBC production); normal in aplastic anemia (though marrow hypocellular), myelofibrosis (marrow hypocellular), multiple myeloma, lymphoma, anemia of chronic disease. Some centers use the term M:E (myeloid to erythroid) ratio; normal value is 2:1 and increases with diseases that promote myeloid activity or inhibit erythroid activity and decreases with diseases that inhibit myeloid activity or promote erythroid activity.