Neoplastic cells of childhood acute lymphoblastic leukemia (ALL) with natural killer (NK) cell properties were studied for the expression of p75 interleukin-2 receptors (IL-2R) and the receptor functions. Freshly prepared blast cells from a patient with ALL had NK cell properties: (1) the phenotype such as CD56+, CD2+, E-rosette+, CD3-, and CD19-; and (2) the presence of spontaneous cytotoxicity against NK-sensitive K562 target cells. Although p55 Tac antigen was not detectable, there was the expression of p75 IL-2R on the freshly prepared blast cells: 70% of the cells reacted with Mik-beta 1 monoclonal antibody against p75 IL-2R as determined by flow cytometry. Two-color flow cytometry revealed that the blast cells expressed both p75 IL-2R and NKH-1. NK activity of the blast cells was augmented by their treatment with 1,000 U/ml recombinant IL-2 (rIL-2): the cytotoxicity level as percentage lysis increased to 38.7% from 22.0% when the normal lymphocyte value increased to 62.1% from 46.2%. Although the blast cells possessed no apparent level of proliferative capacity, the addition of 1,000 U/ml rIL-2 yielded a 2.7-fold increase in their thymidine uptake. These results demonstrate the expression of functional p75 IL-2R on the patient's blast cells with NK cell properties.