Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Levofloxacin prophylaxis in ALL, AML

Alexander S, et al. JAMA. 2018;320(10):995-1004

Key clinical point: Levofloxacin prophylaxis significantly reduced bacteremia in children with acute leukemias undergoing intensive chemotherapy, but not in children undergoing hematopoietic stem cell transplantation (HSCT).

Major finding: Bacteremia likelihood was 21.9% versus 43.4% for prophylaxis and no prophylaxis, respectively, in the acute leukemias group (P = 0.001), and 11.0% versus 17.3% in the HSCT group (P = 0.06).

Study details: A randomized phase 3 clinical trial, including 200 patients with acute leukemias and 424 patients undergoing HSCT.

Disclosures: The research was supported by grants from the Community Clinical Oncology Program and National Cancer Institute. Study authors reported disclosures related to Bristol-Myers Squibb, Chimerix, Jazz Pharmaceuticals, and the Children’s Oncology Group.

Read the article here.


Alexander S, et al. JAMA. 2018;320(10):995-1004.

Must Reads in ALL

Immune system changes play a role in AML relapse, Christopher MJ et al. N Engl J Med. 2018 Oct 31. doi: 10.1056/NEJMoa1808777.

CAR T-cell cost effectiveness in ALL, Whittington MD et al. JAMA Pediatr. 2018 Oct 8. doi: 10.1001/jamapediatrics.2018.2530

CAR T induced resistance in ALL, Ruella M et al. Nat Med. 2018 Oct 1. doi: 10.1038/s41591-018-0201-9

ALL complications carry cognitive risks, Cheung YT et al. JAMA Pediatr. 2018 Sep 24. doi:10.1001/jamapediatrics.2018.2500.