The glycophorin A assay was used to estimate the frequency of mutations that accumulate in vivo in somatic cells of persons with Bloom's syndrome (BS). This assay measures the frequency in persons of blood type MN of variant erythrocytes that lack the expression of one allelic form of glycophorin A, presumably due to mutational or recombinational events in erythroid precursor cells. Samples of blood from persons with BS showed dramatic 50-to 100-fold increases in the frequency of variants of three types, those with a hemizygous phenotype, those with a homozygous phenotype, and those with what appears to be partial loss of the expression of one locus. The high frequency of homozygous variants, genetic evidence for altered allelic segregation of a specific biochemical locus, provides evidence for increased somatic crossing-over in vivo in BS. An increased generation of functional hemizygosity and homozygosity in their somatic cells may play an important role in the extreme cancer risk of persons with BS.Bloom's syndrome (BS) (1) is a rare autosomal recessive genetic disorder of growth that greatly increases the affected individual's chance of developing cancer. In the 130 affected individuals in the Bloom's Syndrome Registry, 57 malignant neoplasms have been detected, at a mean age at diagnosis of 24.7 years (2). A wide spectrum of tumor types has been observed in affected individuals, including lymphoid and myeloid leukemias, lymphomas, squamous cell carcinomas, and adenocarcinomas (3).In addition, a distinctive array of cytological abnormalities in a variety of cell types, signifying a remarkable degree of genomic instability, is a constant feature of BS (4, 5). These include high spontaneous frequencies of chromosome breaks and rearrangements (5-8), sister-chromatid exchanges (SCEs) (5, 9-11), micronucleated cells (12, 13), and cells with specific-locus mutations (14-17). A unique cellular abnormality in untreated BS cells in vitro is a dramatic increase over normal in the frequency of a certain type of quadriradial configuration (Qr) in metaphase cells (5,18). The Qrs of BS are the microscopically visible consequence of interchanges that, earlier in the cell cycle, occurred between homologous chromosomes at apparently homologous sites; they are interpreted as cytological evidence for an increased frequency of somatic crossing-over in BS (18)(19)(20)(21). Heterozygous carriers of the BS mutation (bl/+) are clinically and cytologically normal (22). Although the primary genetic defect responsible for BS may not have been defined, DNA ligase I activity has been reported to be decreased (23)(24)(25), and this very possibly is responsible for the genomic instability of BS. The complex cytogenetic abnormalities readily demonstrable in BS cells in vitro raise the possibility that somatic cell mutation (point mutation, chromosome segmental rearrangement, and somatic recombination) is also substantially increased in vivo in BS, and this could explain the extreme cancer risk.In the present study we have used the ...