Summary.We report three novel variants of band 3 associated with hereditary spherocytosis: band 3 Foggia (311delC; ACCCAC → ACCAC), band 3 Napoli I (447insT; TCT → TTCT) and band 3 Napoli II (I783N; ATC → AAC). The first two mutations resulted in premature termination of translation, making one haploid set of band 3 mRNA unavailable. Since it affected a highly conserved position at the terminal end of transmembrane domain 11, the third mutation prevented one haploid set of band 3 from becoming incorporated or stabilized into the membrane. These three mutations resulted in a reduction of the band 3 level in the red cell membrane (by 20-25%) and were dominantly transmitted. The D38A substitution (GAC → GCC) is a low frequency change of band 3. In one compound heterozygote D38A/Napoli II, a markedly aggravated picture required early splenectomy. In contrast, the D38A change was not associated with deterioration in another compound heterozygote, carrying in trans, the previously recorded R760W mutation (CGG → TGG). In the aggravated case, SSCP analysis did not exhibit any additional change in the two EPB3 alleles. Nor did it show any alteration in the exons of the two ANK1 alleles, and the aggravating factor remained elusive. The D38A alteration should be regarded as an innocuous polymorphism.Keywords: hereditary spherocytosis, band 3, EPB3 gene, mutations, polymorphism.Hereditary spherocytosis (HS) is a common inherited haemolytic anaemia characterized by spheroidal, osmotically fragile, erythrocytes (for review, see Lux & Palek, 1995). The primary molecular defect can reside in several red cell membrane structural proteins: spectrin, ankyrin, band 3 and protein 4.2. Band 3, or the anion exchanger 1 (AE1), is the most abundant protein of the red cell membrane (1 : 2 × 10 6 monomers per cell) and consists of two domains with distinct functions (for review, see Tanner, 1993). The cytoplasmic domain (residues 1-403) binds a number of proteins including ankyrin and protein 4.2. The membrane domain (residues 404-883) harbours 14 membrane-spanning segments (TM) and mediates chloride-bicarbonate passive antiport. Band 3 cDNA has been entirely sequenced (Tanner et al, 1988;Lux et al, 1989;Schofield et al, 1994), and the structure of the band 3 gene (EPB3) has been determined (Schofield et al, 1994;Sahr et al, 1994). Approximately 20% of HS cases are associated with a substantial reduction of the band 3 amount in the red cell membrane (20-40%). Basically, their inheritance pattern is autosomal dominant and their clinical phenotype is mild to moderate in the heterozygous state. Band 3 deficiency is accompanied by a roughly proportional reduction in protein 4.2. Several mutations leading to band 3 reduction and HS have been recently identified. They include (i) mutations producing premature termination of translation (at any position along the whole coding sequence) and (ii) substitutions of highly conserved amino acids within the membrane domain, especially in the last membrane spanning segments (TM9-TM14) or at their bounda...