Acute myelogenous leukemia (AML) blasts derived from 20 patients were examined for expression of high- (Fc(epsilon)RI) and low-affinity (Fc(epsilon)RII, CD23) IgE Fc(epsilon)-receptors. Fc(epsilon)RI expression was not detected for any patient. In contrast, expression of CD23 (at least 15% of the blasts stained positive) was detected for 6 out of the 20 patients. Acute lymphoblastic leukemia (ALL) blasts derived from 12 patients did not express CD23 (<1% positive cells for all patients). The functional effects of Fc(epsilon)R-receptor ligation were also examined for 20 patients, including the five patients with highest CD23 expression (30-55% positive cells) and five patients with verified low CD23 expression (<or=7% positive cells). The presence of IgE during in vitro culture altered the functional characteristics (spontaneous and cytokine-dependent proliferation, colony formation, cytokine secretion, or spontaneous in vitro apoptosis) of AML blasts for a subset of both CD23-positive patients and certain patients with very low CD23 expression. This last observation suggests that Fc(epsilon)R are either expressed at a very low level or receptors are expressed only by a minor cell subset for these patients. We conclude that functional Fc(epsilon)R can be expressed by human AML cells.