A differentiation of treated versus untreated megaloblastic anemia can be determined by the presence of:

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Polychromasia, or the presence of nucleated red blood cells or cells with residual RNA, is seen in treated megaloblastic anemia due to increased erythropoiesis. Untreated megaloblastic anemia would not have polychromasia as there is impaired erythropoiesis. Hypochromia and siderocytes are typically seen in iron-deficiency anemia, while Howell-Jolly bodies are associated with asplenia or splenic dysfunction.

A Differentiation of Treated Versus Untreated Megaloblastic Anemia Can Be