Identification of the specific cytogenetic abnormality is one of the critical steps for classification of acute myeloblastic leukemia (AML) which influences the selection of appropriate therapy and provides information about disease prognosis. However at present, the genetic complexity of AML is only partially understood. To obtain a comprehensive, unbiased, quantitative measure, we performed serial analysis of gene expression (SAGE) on CD15 ؉ myeloid progenitor cells from 22 AML patients who had four of the most common translocations, namely t(8;21), t(15;17), t(9;11), and inv(16). The quantitative data provide clear evidence that the major change in all these translocation-carrying leukemias is a decrease in expression of the majority of transcripts compared with normal CD15 ؉ cells. From a total of 1,247,535 SAGE tags, we identified 2,604 transcripts whose expression was significantly altered in these leukemias compared with normal myeloid progenitor cells. The gene ontology of the 1,110 transcripts that matched known genes revealed that each translocation had a uniquely altered profile in various functional categories including regulation of transcription, cell cycle, protein synthesis, and apoptosis. Our global analysis of gene expression of common translocations in AML can focus attention on the function of the genes with altered expression for future biological studies as well as highlight genes͞pathways for more specifically targeted therapy.hematopoietic cell differention ͉ diagnostic microarray T he pathogenesis of acute myeloid leukemia (AML) in many patients is linked to oncogenic fusion proteins, generated as a consequence of chromosome translocations or inversions (1). Many different translocations have been described in AML, the most frequent being the t(9;11), t(15;17), t(8;21), and inv(16), which, taken together with their variants, account for Ϸ20-30% of AML cases (2, 3), although a recent analysis by Mitelman et al. (4) suggests that the proportion may be closer to 10%. These recurring translocations are now the basis for classification of some patients with AML. Despite genetic heterogeneity, there is increasing evidence for some common molecular and biological mechanisms in the genesis of AML. In particular, one of the components of each fusion protein is almost invariably a transcription factor, frequently involved in the regulation of myeloid cell differentiation (5). As a consequence, AML-associated fusion proteins function as aberrant transcriptional regulators with the potential to interfere with the normal processes of myeloid cell differentiation.Genome-wide gene expression profiling is becoming useful for the classification of many types of cancer (6, 7), including AML and acute lymphoblastic leukemia (8-15). Although AML subtypes can be distinguished by oligonucleotide microarrays, the results of analysis of different translocations between laboratories are not always similar. This lack of consistency has probably resulted from the heterogeneous nature of clinical samples (age, se...