This study evaluated the utility of human blood micronucleated reticulocyte (MN CD71+ ) frequency measurement as a cytogenetic damage biomarker. The analytical methodology was flow cytometry in conjunction with a previously described three color fluorescence labeling technique that includes anti-CD71 to focus analyses on the most immature fraction of reticulocytes [Dertinger et al., Environ. Molec. Mutagen., 44:427-435 (2004)]. Blood specimens from fifty self-reported healthy adult volunteers were studied. In addition to MN CD71+ measurements, blood plasma folate and B 12 levels were assessed, since these variables tend to influence other indices of cytogenetic damage. Timecourse data are also provided for ten cancer patients undergoing treatment. For these subjects, frequency of MN CD71+ was measured immediately before therapy, and daily during the first week of chemotherapy and/or fractionated radiotherapy. For the group of healthy volunteers, the variables of age, and folate and B 12 levels demonstrated no significant effect on MN CD71+ frequency. In addition, no difference was observed between pre-treatment MN CD71+ values for cancer patients compared with healthy volunteers. Regarding chemotherapy and/or partial body radiotherapy, elevated frequencies were observed upon initiation of treatment for 9 of the 10 patients studied. Maximal effects were observed three to five days following initiation of therapy. The largest increases in frequency of MN CD71+ (up to 25.9-fold) were observed in those patients exposed to anti-neoplastic drugs, presumably due to the systemic red marrow exposure provided by these agents. Taken together, these data support the hypothesis that the MN CD71+ endpoint represents a valuable biomarker of cytogenetic damage that does not require cell culture or microscopy-based scoring.