Previous studies demonstrated an enhancing effect of granulocyte-macrophage colony-stimulating-factor (GM-CSF) on natural cytotoxicity. It was the aim of this study to investigate if CD56(+) natural-killer (NK) cells are responsible for the increased natural cytotoxicity after GM-CSF treatment. NK-cells were incubated with or without GM-CSF and Interferon-alpha (IFN-alpha) at various concentrations. NK-activity was determined by their ability to lyse NK-sensitive tumor cells (K562) and by cell surface expression of activation markers (CD25 and CD69). In our experimental setting incubation of CD56(+) NK-cells with GM-CSF did not significantly alter NK-cell mediated cytotoxicity or the expression of activation markers. In contrast, pre-treatment with IFN-alpha, a well known stimulant of NK-activity enhanced cytotoxicity by 69.2%+/-13.2%, P<0.05, effector/target cell ratio (E/T) 10:1 and by 43.3%+/-17.3%, P<0.05, E/T 20:1 and increased the expression of CD69 and CD25. Our results suggest that GM-CSF treatment alone cannot enhance natural cytotoxicity mediated by CD56(+) NK-cells in vitro.