The MDR1 gene is of prognostic significance in acute myeloid leukemia (AML). The relationship of this gene to surface markers largely remains unclear. Therefore, we have studied the association of MDR1 gene expression with the expression of specific surface markers in AML. MDR1 RNA expression of leukemic cells was determined by slot blot analysis. Expression of P-glycoprotein and surface markers (CD7, CD13, CD19, CD34, HLA-DR, TdT, blood group H) was assessed by immunocytochemistry. MDR1 RNA (n = 79) and P-glycoprotein (n = 52) expression were detected in 63% and 63% of the patients, respectively. CD7, CD13, CD19, CD34, HLA-DR, TdT and blood group H were positive in 17%, 84%, 0%, 51%, 82%, 11% and 11% of the patients. MDR1 RNA or P-glycoprotein expression were not associated with the expression of either CD7, CD13, CD19, CD34, TdT or blood group H. However, P-glycoprotein expression was more frequent in HLA-DR positive than in HLA-DR negative patients (47% versus 10%, p = 0,04). Consistent with the latter finding, patients with intermediate or high MDR1 RNA expression expressed HLA-DR more frequently than patients with negative or weak MDR1 RNA expression (96% versus 76%, p = 0,03). In conclusion, MDR1 gene expression of AML cells was independent of surface markers except HLA-DR.