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I think I figured out the problem I was having.
Essentially the documentation is misleading. DEF-FIXTURE does not define a "macro", but the body of a "function" where &BODY (*) is available as a MACROLET to include the TEST/DEF-TEST expressions.
My problem was that I was treating DEF-FIXTURE as a macro, trying to produce code. It is not. removing the backquote I was using fixed all my problems.
Changing the documentation would make things easier to understand.
(*) Changing the &BODY MACROLET name would also help.