Both human recombinant tumor necrosis factor alpha (TNF alpha) and all-trans-retinoic acid (RA) inhibit the in vitro clonal growth of human myeloid leukemic cells. We investigated the in vitro interaction of TNF alpha and RA with normal and a variety of leukemic myeloid cells. With the promyelocytic HL-60 cells, TNF alpha (greater than or equal to 2.5 U/mL) in combination with RA synergistically inhibited clonal growth; TNF alpha at lower concentrations (less than or equal to 1 U/mL) plus RA (10(-9) mol/L) were antagonistic in their inhibition of growth. The ability of RA (10(-8) mol/L) plus TNF alpha (2.5, 5 U/mL) to enhance differentiation of HL-60 cells paralleled their ability to inhibit clonal growth of these cells. In addition, RA (10(-9) to 10(-7) mol/L) increased the number of TNF alpha receptors on HL-60 cells 1.3- to 1.7-fold without changing the affinity for the TNF alpha receptor. With the more immature KG-1 myeloblasts, concentrations of TNF alpha greater than 10 U/mL synergistically interacted with RA to inhibit clonal growth; at lower concentrations of TNF alpha (less than 10 U/mL), RA appeared to inhibit the expected effect of TNF alpha. KG-1 cells were not induced to differentiate with either agent alone or in combination. With four of nine leukemic patients, TNF alpha in combination with RA (10(-7) mol/L) inhibited leukemic clonal growth to a greater extent than each agent alone. No marked effect of the combined treatment was seen in two other patients. The RA reversed the inhibitory action of TNF alpha on normal human granulocyte-macrophage colony forming cells (GM-CFC) and on clonal growth of leukemic cells from three patients. Our study suggests that TNF alpha and RA interact in a complex manner with normal and leukemic hematopoietic cells.