Core-binding factors (CBFs) are a small family of heterodimeric transcription factors that play critical roles in hematopoiesis and in the development of bone, stomach epithelium, and proprioceptive neurons. Mutations in CBF genes are found in leukemias, bone disorders, and gastric cancer. CBFs consist of a DNA-binding CBF␣ subunit and a non-DNA-binding CBF subunit. DNA binding and heterodimerization with CBF are mediated by the Runt domain in CBF␣. Here we report an alanine-scanning mutagenesis study of the Runt domain that targeted amino acids identified by structural studies to reside at the DNA or CBF interface, as well as amino acids mutated in human disease. We determined the energy contributed by each of the DNA-contacting residues in the Runt domain to DNA binding both in the absence and presence of CBF. We propose mechanisms by which mutations in the Runt domain found in hematopoietic and bone disorders affect its affinity for DNA.The core-binding factors (CBFs) 1 are a small family of heterodimeric transcription factors that play critical roles both in mammalian development and in human disease. CBF␣ subunits are encoded by three related genes, RUNX1, RUNX2, and RUNX3 (1-3), whereas the common CBF subunit is encoded by a single gene called CBFB (4, 5). Genetic loss-and gain-of-function studies in mice documented roles for the CBF proteins in at least four developmental processes. Runx1 and Cbfb are required for definitive hematopoiesis (6 -9), and both Runx2 and Cbfb are required for bone formation (10 -14). The Runx3 gene is required for proper development of the stomach epithelium (15), for the development of a subset of sensory neurons (16,17), and for epigenetic silencing of the CD4 gene in T lymphocytes (18). Lack of RUNX3 function is causally related to the genesis and progression of human gastric cancer (15).RUNX1 and CBFB are frequent targets of mutations in human leukemias (19,20). RUNX1 is disrupted by the t(8; 21)(q22;q22) in 15% of de novo acute myeloid leukemia (AML M 2 subtype) (2, 21), the t(12;21)(p13;q22) in 30% of pediatric de novo acute lymphoblastic leukemia (22-25), and by the relatively rare t(1;21)(p36;q22), t(3;21)(q26;q22), t(5;21)(q13;q22), t(12;21)(q24;q22), t(14;21)(q22;q22), t(15;21)(q22;q22), t(16; 21)(q24;q22), and t(17;21)(q11.2;q22) in the therapy-related leukemias and myelodysplasias (MDS) (2, 22, 23, 26 -29). Biallelic point mutations in RUNX1 are found in AML of the M 0 subtype (30 -32). RUNX1 mutations in AML M 0 include both nonsense mutations that introduce premature termination codons and missense mutations. Monoallelic point mutations in RUNX1 were identified in AML M 0 , MDS, pediatric acute lymphoblastic leukemia, and chronic myelogenous leukemia in blast crisis (30 -33). In addition, haploinsufficiency of the RUNX1 gene is responsible for a rare familial platelet disorder with propensity for acute myelogenous leukemia (FPD/AML) (34 -36).The RUNX2 gene is also the target of mutations that are responsible for an inherited human skeletal disorder called c...