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Acute and chronic liver dysfunction is common after allogeneic bone marrow transplantation (BMT). Although toxicity, graft versus-host disease (GVHD), and viral infections are the major causes, etiologic diagnosis is difficult and often remains unknown. We conducted a prospective study to establish the role of the infection with both the hepatitis C virus (HCV) and the recently discovered hepatitis G virus (HGV) in liver dysfunction after BMT. From January 1994 to December 1995, 59 patients who had undergone an allogeneic BMT at our institution were enrolled in the study. HGV-RNA was identified in serum by nested polymerase chain reaction (PCR), and HCV was studied by the presence of second generation enzyme-linked immunosorbent assay (ELISA)-antibodies and HCV-RNA by nested PCR. HGV-RNA was detected in 25 patients (42%) (before BMT in 18 and after BMT in 7). HCV-RNA was present in 12 patients (20%) (before BMT in 11 and after BMT in one). The presence of HCV-RNA and HGV-RNA was clearly associated with a previous history of blood transfusions. No significant association was found between viral infection and acute liver toxicity. Some degree of liver dysfunction was present 6 months after BMT in 25 of 40 evaluable patients (62%). Long-term liver dysfunction was more common among patients infected with HCV alone (3 of 4) or with both HCV and HGV (3 of 3) than in those infected with either HGV alone (eight of 13) or with no virus infection (10 of 20). We found a high prevalence of HGV infection in our BMT population. However, no role for HGV in liver disease could be established in this study, and the relationship between HGV infection and liver dysfunction requires further clarification.

Abstract 3920 Poster Board III-856 Introduction Accurate staging is critical in patients with lymphoma. Despite the lack of functional information CT remains the standard imaging technique based on anatomic criteria. PET with FDG provides functional evaluation but lacks of specificity due to the absence of anatomic landmarks. We have prospectively compared the accuracy of combined PET/CT with that of CT and PET alone at initial staging in lymphoma patients. Material and Methods. Patients with newly diagnosed lymphoma were prospectively included in the study. All patients underwent conventional staging studies which included clinical history, physical examination, laboratory work-up, biopsy of enlarged lymph node and of the iliac crest bone marrow, and PET/CT (either with full-dose contrast enhanced CT (FD PET/CT) and with low-dose non-enhanced CT (LD-PET/CT)) before starting therapy. The combined results of the clinical and imaging studies and the results of biopsies of suspected sites involved with lymphoma, when possible, formed the basis of our reference standard. The primary objective of the study was to address the accuracy of the PET/CT examination in clinical staging. For each patient, staging was assessed according to the Ann Arbor classification system on the basis of CT, PET images alone and the PET/CT images. The results were then compared with the true clinical stage based on the reference standard. Secondary objectives were: evaluation of the influence of clinical staging with PET/CT in the treatment approach, assessment of the efficacy of PET in evaluating bone marrow (BM) involvement, and definition of the accuracy of PET/CT imaging in the staging of different histologic subgroups. Results. 108 patients (64 female and 44 male; mean age 50 years; range 18-75 years) were included in the study. 76 patients had NHL and 32 had HL. 36% of the patients (28) had DLBCL whereas 18% (14 patients) had Follicular lymphoma. Other subtypes of NHL accounted for less than 10%. 31 of HL patients had classic variants. True clinical stage for NHL patients was I (7), II (11), III (6) and IV (52), and for HL was II (17), III (4) and IV (10). Agreement in staging was statistically significant between the reference standard and the staging algorithms by CT (k=0.493 p Disclosures: No relevant conflicts of interest to declare.