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Updated: May 26, 2026

Murine Model of Leukemia Relapse to Induction Chemotherapy for Acute Lymphoblastic Leukemia
Published on: October 17, 2025
Recommendations for broader coverage antifungal prophylaxis in childhood acute myeloid leukemia: ASH evidence-based
Maria M Gramatges1, Stuart S Winter
1Texas Children's Cancer and Hematology Centers, Baylor College of Medicine, Houston, TX 77030, USA. mmgramat@txch.org
Abstract:
A 16-year-old female diagnosed with acute myeloid leukemia (AML) with inversion 16, a favorable prognostic indicator, has persistent neutropenia after her fourth cycle of dose-intensified chemotherapy. She was recently admitted for treatment with empiric antibiotics for febrile neutropenia, and an astute intern noticed a new lesion on her right foot with a dark necrotic center. A biopsy of the lesion showed spreading hyphae, consistent with Aspergillus. Despite her compliance with fluconazole fungal prophylaxis, computed tomography imaging revealed disseminated aspergillosis involving her lungs, liver, and kidneys. Amphotericin was started, but systemic fungemia and the development of multiorgan failure resulted in her death. You are in the difficult position of having to explain to her parents that she died in remission from chemotherapy-related complications. All of those involved in this unfortunate scenario wonder if something could have been done to prevent her death.
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