Abstract. The rate of endogenous carbon monoxide production (Vco), determined by the closed rebreathing system technique, was elevated above the normal range in four of five patients studied with ineffective erythropoiesis (four patients with primary refractory anemia, one with thalassemia). The mean molar ratio of Vco to Vheme (rate of circulating heme catabolism, determined from 51Cr red cell survival curves) was 3.0 ± 0.6 (SE), indicating that most of the CO originated from sources other than circulating erythrocyte hemoglobin, in contrast to previous findings in patients with hemolytic anemia, where Vco paralleled Vheme closely.After administration of glycine-2-4C to these patients, endogenous CO was isolated by washout of body CO stores at high PO2 or by reacting peripheral venous blood samples with ferricyanide. The CO was then oxidized to CO2 by palladium chloride and trapped for counting in a liquid scintillation spectrometer.