Mutation or deletion of the retinoblastoma tumor suppressor gene (Rb) or abnormal Rb protein expression is found in many types of human solid tumors. Low or absent levels of Rb protein are usually found in the leukemic cells of patients with acute myelogenous leukemia (AML) who have an extremely poor prognosis. The absence of Rb protein in these AML cells could result from defects in the Rb gene or from abnormal cell cycle regulation that affects Rb expression. To test these possibilities and to examine whether a low level of Rb protein in AML cells could be up-regulated, we studied the effect that growth factors interleukin 3 (IL3) and granulocyte-macrophage colony stimulating factor (GM-CSF) had on the levels of Rb protein and Rb phosphorylation in AML cells from patients with low Rb or no Rb protein expression. We observed three responses to growth factor-stimulation in leukemic cells taken from patients with AML: (1) some AML cell samples entered a proliferative phase, and Rb protein levels increased with the appearance of normally phosphorylated forms of Rb protein and positive nuclear staining for Rb protein; (2) some AML cell samples became more proliferative, but the levels of Rb protein remained low or absent; and (3) some AML cell samples showed no response. These results indicate that at least two different mechanisms may be responsible for the lack of Rb protein in the leukemic cells of some patients with AML.