DNA topoisomerase I (Top1) is essential for removing DNA supercoiling generated in transcribing and replicating chromatin (11,67). Top1 relaxes positively and negatively supercoiled DNA by introducing reversible DNA single-strand breaks associated with covalent Top1-DNA complexes. Camptothecin, a natural alkaloid, selectively targets the Top1-DNA complex by stabilizing the covalent Top1-DNA cleavage intermediate (33,47,65). Camptothecin and its derivatives, irinotecan and topotecan, are potent anticancer drugs currently being used successfully in the treatment of colon and ovarian cancer (4,46,64). The cytotoxic action of camptothecin is manifested when a replication fork encounters the drug-stabilized cleavage complex (31, 34). At these sites, extension of the replicating strand up to the end of the Top1-mediated break in the template strand generates a replication double-strand break ("replication runoff") as demonstrated by ligation-mediated PCR (62) and the induction of ␥-H2AX (23) (http://discover.nci.nih.gov/ pommier/pommier.htm). Camptothecin is, therefore, a wellcharacterized pharmacological tool for studying the molecular mechanisms involved in cellular responses to replicative stress (23,48,59,62). Top1 cleavage complexes and, therefore, replication double-strand breaks can form in response to common DNA lesions including abasic sites, mismatches, oxidative base lesions, base adducts, and strand breaks (49, 51).Histone H2AX phosphorylated on serine 139, termed ␥-H2AX, is one of the earliest known markers of camptothecin-induced replication-associated damage (23). More generally, ␥-H2AX is a marker of DNA double-strand breaks (45, 54). ␥-H2AX has been proposed to anchor the broken chromosome ends together and recruit DNA repair elements (5,20,23,45,53). We have shown previously that ␥-H2AX is critical for the recruitment of the Mre11-Rad50-Nbs1 (MRN) complex in camptothecin-treated cells and that H2AX deficiency renders cells hypersensitive to camptothecin (23,53). Using aphidicolin, we also showed that blocking replicative polymerases abrogates ␥-H2AX formation (23), indicating that ␥-H2AX forms in response to replication-associated doublestrand breaks induced by camptothecin.The causative gene of the cancer-predisposing genetic disease Bloom's syndrome, BLM, is a member of the RecQ family of DNA helicases (28). BLM is considered a caretaker of the genome (28, 39) and a key component in DNA damage response signaling (22,52). Evolutionarily conserved and essential for the maintenance of genomic stability, BLM promotes branch migration of Holliday junctions in vitro in an ATPdriven fashion (36,38,40,66,70). BLM functions in association with topoisomerase III␣ (Top3␣) (68), a type I class of topoisomerases (11,37,67,69). The BLM-Top3␣ complex can resolve recombination intermediates and prevent the collapse of replication forks and consequent DNA double-strand