Topoisomerase II (Top2) is an important target for anticancer therapy. A variety of drugs that poison Top2, including several epipodophyllotoxins, anthracyclines, and anthracenediones, are widely used in the clinic for both hematologic and solid tumors. The poisoning of Top2 involves the formation of a reaction intermediate Top2-DNA, termed Top2 cleavage complex (Top2cc), which is persistent in the presence of the drug and involves a 5 0 end of DNA covalently bound to a tyrosine from the enzyme through a phosphodiester group. Drug-induced Top2cc leads to Top2 linked-DNA breaks which are the major responsible for their cytotoxicity. While biochemical detection is very laborious, quantification of drug-induced Top2cc by immunofluorescence-based microscopy techniques is time consuming and requires extensive image segmentation for the analysis of a small population of cells. Here, we developed a flow cytometry-based method for the analysis of drug-induced Top2cc. This method allows a rapid analysis of a high number of cells in their cell cycle phase context. Moreover, it can be applied to almost any human cell type, including clinical samples. The methodology is useful for a high-throughput analysis of drugs that poison Top2, allowing not just the discrimination of the Top2 isoform that is targeted but also to track its removal. Key terms flow cytometry; topoisomerase II; Top2 poison; high throughput analysis TOPOISOMERASE II (Top2) is a dimeric enzyme that catalyzes topological changes in the DNA, thus being essential in several metabolic processes of the genome of eukaryotic cells (1,2). In mammals, there have been characterized two variants of Top2, a and b isoforms, showing different activities and regulation of their expression. While Top2a expression and activity increase throughout the cell cycle, Top2b remains at similar levels (3,4). Top2a is essential for cell proliferation, participating in several processes such as replication, transcription, and chromosome condensation and segregation (5). In contrast, Top2b is dispensable for cell proliferation, but contributes to transcription and is required during development (6,7). Top2 acts by nicking both strands of the DNA to allow the passage through it of other doublestranded segment of DNA from the same or a different molecule. Following the breakage of the double-stranded DNA, each monomer of Top2 remains covalently linked to each 5 0 terminus of DNA by a transient phosphotyrosyl linkage, a reaction intermediate termed cleavage complex (Top2cc) (8,9). Certain natural compounds, spontaneous DNA lesions and several chemotherapeutic agents can stabilize the Top2cc increasing their half-life (10-12). These agents interfere with the breakagereunion reaction that leads to a reversible DNA damage, which becomes irreversible