Loss of a whole chromosome S or a deletion of its long arm (5q) is a recurring abnormality in malignant myeloid neoplasms. To determine the location of genes on Sq that may be involved in leukemogenesis, we examined the deleted chromosome 5 homologs in a series of 135 patients with malignant myeloid diseases. By comparing the breakpoints, we identified a small segment of 5q, consisting of band 5q31, that was deleted in each patient. This segment has been termed the critical region. Distal Sq contains a number of genes encoding growth factors, hormone receptors, and proteins involved in signal transduction or transcriptional regulation. These include several genes that are good candidates for a tumorsuppressor gene, as well as the genes encoding five hematopoietic growth factors (CSF2, IL3, IL4, IL5, and IL9). By using fluorescence in situ hybridization, we have refrned the localization of these genes to 5q31.1 and have determined the order of these genes and of other markers within 5q31. By hybridizing probes to metaphase cells with overlapping deletions involving 5q31, we have narrowed the critical region to a smail segment of 5q31 containing the EGRI gene. The five hematopoietic growth factor genes and seven other genes are excluded from this region. The EGRI gene was not deleted in nine other patients with acute myeloid leukemia who did not have abnormalities of chromosome 5. By physical mapping, the minimum size of the critical region was estimated to be 2.8 megabases. This cytogenetic map of 5q31, together with the molecular characterization of the critical region, will facilitate the identification of a putative tumor-suppressor gene in this band.Recurring chromosomal rearrangements are characteristic of human malignant diseases, particularly the leukemias and lymphomas (1) (93%o) had a clonal chromosomal abnormality and 97 (75%) had loss or deletion of chromosome 5 and/or 7. Among these 97 patients, 21 had loss of chromosome 5, 26 had a del(5q), 8 had loss of 5q following unbalanced translocations, 51 had loss of chromosome 7, 11 had a del(7q), and 12 had loss of 7q as a result of an unbalanced translocation. Thirty-one patients had abnormalities of both chromosomes 5 and 7. Overall, 55 patients (43%) had abnormalities of chromosome 5. A del(5q) was the most common structural aberration in our series.In addition to t-MDS/t-AML, a -5/del(Sq) has also been observed in the malignant cells of 10%o ofpatients with AML de novo and in 15% ofpatients who have MDS arising de novo (8). Many of these patients have had significant occupational exposure to potential environmental carcinogens, suggesting that abnormalities of chromosome 5 or 7 may be a marker of mutagen-induced leukemia. A distinct clinical syndrome associated with a del(5q) is seen in a subset ofpatients with MDS de novo. Clinically, this disorder, termed the "5q-syndrome," is characterized by refractory anemia (RA). These patients having a del(Sq) as the sole abnormality tend to have a relatively mild course that usually does not progress to ...