The potential role of the Fas (CD95/APO-1) receptor/ligand system in chemotherapeutic drug-induced apoptosis was examined in a number of human leukaemic cell lines. Flow cytometric profiles of doxorubicin-treated HL-60, K562, U937 and Jurkat cells failed to show any significant increase in Fas or Fas ligand expression over 24 h, despite the induction of significant levels of apoptosis in these cells. Although preincubation of human leukaemic cells with a neutralizing anti-Fas IgG antibody blocked anti-Fas IgM-induced apoptosis, this strategy failed to inhibit chemotherapeutic drug-induced apoptosis. To determine whether recruitment of the Fas/Fas ligand complex during drug-induced apoptosis was a cell-specific event we utilized the CEM cell line. Doxorubicin treatment of CEM cells over 24 h failed to show any up-regulation in Fas or Fas ligand protein levels as detected by flow cytometry. Furthermore, neutralizing anti-Fas IgG Ab failed to inhibit chemotherapeutic drug-induced apoptosis in CEM cells. The present studies do, however, demonstrate a role for anti-Fas IgM Ab in producing a cytotoxic synergistic effect when used in combination with chemotherapeutic drugs. Low-dose anti-Fas IgM treatment in combination with doxorubicin, methotrexate, camptothecin and etoposide produced an augmented cytoxicity in CEM cells. Taken together these observations demonstrate that although recruitment of the Fas/APO-1/CD95 receptor/ligand system is not a necessary requirement for chemotherapeutic drug-induced apoptosis, combination of anti-Fas IgM and drug treatment produces a synergistic cytotoxic effect which may prove useful in the treatment of human leukaemias.