N 1 -ethyl-N 11 -[(cyclopropyl)methyl]-4,8,-diazaundecane (CPENSpm) is a polyamine analogue that represents a new class of antitumor agents that demonstrate phenotype-specific cytotoxic activity. However, the precise mechanism of its selective cytotoxic activity is not known. CPENSpm treatment results in the superinduction of the polyamine catabolic enzyme spermidine͞spermine N 1 -acetyltransferase (SSAT) in sensitive cell types and has been demonstrated to induce programmed cell death (PCD). The catalysis of polyamines by the SSAT͞polyamine oxidase (PAO) pathway produces H 2 O 2 as one product, suggesting that PCD produced by CPENSpm may be, in part, due to oxidative stress as a result of H 2 O 2 production. In the sensitive human nonsmall cell line H157, the coaddition of catalase significantly reduces high molecular weight (HMW) DNA (>50 kb) and nuclear fragmentation. Important to note, specific inhibition of PAO by N,N-bis(2,3-butadienyl)-1,4-butane-diamine results in a significant reduction of the formation of HMW DNA and nuclear fragmentation. In contrast, the coaddition of catalase or PAO inhibitor has no effect on reducing HMW DNA fragmentation induced by N 1 -ethyl-N 11 -[(cycloheptyl)methyl]-4,8,-diazaundecane, which does not induce SSAT and does not deplete intracellular polyamines. These results strongly suggest that H 2 O 2 production by PAO has a role in CPENSpm cytotoxicity in sensitive cells via PCD and demonstrate a potential basis for differential sensitivity to this promising new class of antineoplastic agents. Furthermore, the data suggest a general mechanism by which, under certain stimuli, cells can commit suicide through catabolism of the ubiquitous intracellular polyamines.Programmed cell death (PCD) is a fundamental biological regulatory mechanism involving selective cell deletion. It is an active and irreversible process in which cells activate the intrinsic death program for their own demise. PCD is absolutely required for the natural development and homeostasis of tissues in complex multicellular organisms (1-4). Morphological characteristics of PCD include cell shrinkage, nuclear condensation and fragmentation, plasma and nuclear membrane budding, and apoptotic bodies (3). PCD is biochemically characterized by activation of nucleases that cleave chromosomal DNA into high molecular weight (HMW) and͞or low molecular weight oligonucleosomal DNA fragments (5). PCD can be induced by normal physiological processes and by multiple nonphysiological stimuli, including oxidative stress and chemotherapeutic agents (4-7).The polyamines spermidine and spermine and their diamine precursor putrescine are intracellular cationic molecules that are essential for cell proliferation and differentiation (8, 9). The intracellular concentration of these ubiquitous molecules is highly regulated by the polyamine metabolic pathway, which influences the synthesis, degradation, uptake, and excretion of the cations (9). High ornithine decarboxylase (ODC) activity, the first rate-limiting step of polyami...