The inv(16) is one of the most frequent chromosomal translocations associated with acute myeloid leukemia (AML) and creates a chimeric fusion protein consisting of most of the runt-related X1 co-factor, core binding factor  fused to the smooth muscle myosin heavy chain MYH11. Expression of the ARF tumor suppressor is regulated by runt-related X1, suggesting that the inv (16) The gene encoding the runt-related-X1 (RUNX1, 3 also known as acute myeloid leukemia 1 (AML1)) transcription factor is one of the most frequently mutated genes in human B-cell acute lymphoblastic leukemia (ALL) and AML. RUNX1 is inactivated by bi-allelic mutations in cases of AML with very immature blasts (1, 2) and is also disrupted by the t(12;21), which is the most frequent translocation associated with childhood B-cell ALL (3). Furthermore, RUNX1 is also targeted by many chromosomal translocations in AML, including t(3;21), t(16;21), and t(8;21), and the latter is one of the most frequent translocations (12-15%) in AML (4). Finally, the functions of RUNX1 are also indirectly compromised by the inv(16), which disrupts the gene encoding the RUNX1 co-factor, core binding factor  (CBF). CBF is a small protein that allosterically regulates the ability of RUNX1 to bind to DNA and that blocks the ubiquitin-mediated degradation of RUNX1 (6 -8). The inv(16) occurs in roughly 8% of AML patients and encodes a fusion protein that contains most of CBF fused to a smooth muscle myosin heavy chain (MYH11) (4, 5). (For simplicity, we will refer to the inv(16) fusion protein as the "IFP.") Recent insights suggest that RUNX1 regulates the transcription of genes that can predispose hematopoietic stem cells or progenitor cells to oncogenic transformation. One such target is the p14 ARF (alternative reading frame) tumor suppressor, which regulates the p53-dependent oncogene checkpoint by antagonizing MDM2 functions, thereby stabilizing and activating p53 (9 -13). In murine cells, p19Arf (the murine homolog of human p14 ARF , referred to here collectively as ARF) levels increase in response to various oncoproteins, including v-Abl, c-Myc, Ras, E2F-1, and E1A (11, 14 -17). Thus, loss of ARF impairs p53-mediated growth arrest and/or apoptosis in response to oncogenes.The development of an inv(16) animal model in which to test the mechanism of action of the IFP has been extremely difficult. Previous murine models of the inv(16) have involved the expression of the IFP coupled with either ENU mutagenesis, retroviral insertional mutagenesis (18,19), the removal of two tumor suppressors (20), or the coexpression of oncogenes (20,21). However, only the use of chimeric mice carrying a "knock-in" inv(16) allele plus random mutagenesis yielded an AML that mimicked the human disease (18,19).Given that RUNX1 and RUNX1-ETO (Eight-Twenty-One) regulate the activity of the ARF promoter (22), we reasoned that the IFP may also influence Arf expression and that this pathway would be operational in myeloid leukemogenesis. We demonstrated, in a bone marrow transplant (BMT) mo...