Research Summary

Dr. Lena Winestone is clinically focused on pediatric blood and marrow transplant for high risk leukemias. Dr. Winestone's research explores racial, ethnic, and socioeconomic disparities in access to care and outcome of leukemia and lymphoma treatment. She studies access to care across the continuum of pediatric cancer from diagnosis and clinical trial enrollment through treatment and relapse to salvage therapies. Her research has shown that African American children with acute lymphoblastic leukemia, acute myeloid leukemia, and mature B cell lymphoma are two times more likely to present with organ failure at the time of a new cancer diagnosis. Her ongoing work investigates access to highly specialized and complex therapies such as stem cell transplant, chimeric antigen receptor T cells, and MIBG therapy.

Research Funding

  • July 1, 2020 - February 4, 2023 - Barriers to Care Questionnaire for Pediatric Patients with Leukemia , Principal Investigator . Sponsor: American Society of Hematology, Sponsor Award ID:
  • June 15, 2020 - February 4, 2023 - Work Flexibility and Financial Impact Among Families of Children with Cancer , Supervisor . Sponsor: UCSF Clinical & Translational Science Institute, Sponsor Award ID:
  • February 1, 2020 - February 4, 2023 - Access to MIBG Therapy for High Risk Neuroblastoma Patients , Principal Investigator . Sponsor: American Cancer Society, Sponsor Award ID:
  • December 1, 2018 - February 4, 2023 - In Depth Interviews regarding the Path to a Leukemia Diagnosis , Principal Investivator . Sponsor: Alex's Lemonade Stand Foundation, Bear Necessities Pediatric Cancer Foundation, Sponsor Award ID:

Education

University of Pennsylvania, B.A., 2000-2004, Biochemistry
University of Pennsylvania, M.S., 2002-2004, Immunology
Stanford University School of Medicine, M.D., 2005-2009, Medicine
Lucile Packard Children’s Hospital, Residency, 2009-2012, Pediatrics
The Children’s Hospital of Philadelphia, Fellowship, 2013-2016, Hematology/Oncology
University of Pennsylvania, M.S., 2014-2016, Health Policy

Honors & Awards

  • 2000
    Vagelos Scholars Fellowship in Molecular Life Sciences, University of Pennsylvania
  • 2004
    Helix Prize, University of Pennsylvania Biochemistry Program
  • 2006
    Medical Scholars Research Fellowship, Stanford Medical School
  • 2006
    Fulbright-Hays Fellowship–Intensive Advanced Swahili, U.S. Department of Education
  • 2007
    Traveling Scholar Research Fellowship, Stanford Medical School
  • 2008
    Foreign Language Area Studies Fellowship, U.S. Department of Education
  • 2010 - 2012
    Mary Duke Biddle Clinical Scholars Program
  • 2011 - 2012
    Yale/Stanford Johnson & Johnson Global Health Scholars Program
  • 2015
    Children's Oncology Group Young Investigator Abstract Award
  • 2015
    American Society of Hematology Abstract Achievement Award
  • 2016
    Paul Calabresi Career Development Award for Clinical Oncology, Abramson Cancer Center
  • 2016
    Clinical Research Training Institute, American Society of Hematology
  • 2016
    Alex's Lemonade Stand Foundation Young Investigator Award
  • 2016
    Bear Necessities Fellow Award

Selected Publications

  1. Gupta S, Dai Y, Chen Z, Winestone LE, Teachey DT, Bona K, Aplenc R, Rabin KR, Zweidler-McKay P, Carroll AJ, Heerema NA, Gastier-Foster J, Borowitz MJ, Wood BL, Maloney KW, Mattano LA, Larsen EC, Angiolillo AL, Burke MJ, Salzer WL, Winter SS, Brown PA, Guest EM, Dunsmore KP, Kairalla JA, Winick NJ, Carroll WL, Raetz EA, Hunger SP, Loh ML, Devidas M. Racial and ethnic disparities in childhood and young adult acute lymphocytic leukaemia: secondary analyses of eight Children's Oncology Group cohort trials. Lancet Haematol. 2023 Feb; 10(2):e129-e141.  View on PubMed
  2. Wyatt KD, Noyd DH, Wood NM, Phillips CA, Miller TP, Rubin EM, Winestone LE, Waanders AJ, Perentesis JP, Aplenc R. Data standards in pediatric oncology: Past, present, and future. Pediatr Blood Cancer. 2022 Dec 10; e30128.  View on PubMed
  3. Newman H, Li Y, Liu H, Myers RM, Tam V, DiNofia A, Wray L, Rheingold SR, Callahan C, White C, Baniewicz D, Winestone LE, Kadauke S, Diorio C, June CH, Getz K, Aplenc R, Teachey DT, Maude SL, Grupp SA, Bona K, Barz Leahy A. Impact of poverty and neighborhood opportunity on outcomes for children treated with CD19-directed CAR T-cell therapy. Blood. 2022 Nov 09.  View on PubMed
  4. Boyiadzis M, Zhang MJ, Chen K, Abdel-Azim H, Abid MB, Aljurf M, Bacher U, Badar T, Badawy SM, Battiwalla M, Bejanyan N, Bhatt VR, Brown VI, Castillo P, Cerny J, Copelan EA, Craddock C, Dholaria B, Perez MAD, Ebens CL, Gale RP, Ganguly S, Gowda L, Grunwald MR, Hashmi S, Hildebrandt GC, Iqbal M, Jamy O, Kharfan-Dabaja MA, Khera N, Lazarus HM, Lin R, Modi D, Nathan S, Nishihori T, Patel SS, Pawarode A, Sharma A, Solh M, Wagner JL, Wang T, Williams KM, Winestone LE, Wirk B, Hourigan CS, Litzow M, Kebriaei P, de Lima M, Page K, Weisdorf DJ. Impact of pre-transplant induction and consolidation cycles on AML allogeneic transplant outcomes: a CIBMTR analysis in 3113 AML patients. Leukemia. 2022 Oct 30.  View on PubMed
  5. Chow EJ, Winestone LE, Lupo PJ, Diller LR, Henderson TO, Kadan-Lottick NS, Levine JM, Ness KK, Bhatia S, Armenian SH. Leveraging Clinical Trial Populations and Data from the Children's Oncology Group for Cancer Survivorship Research. Cancer Epidemiol Biomarkers Prev. 2022 09 02; 31(9):1675-1682.  View on PubMed
  6. Namjoshi NS, Keegan THM, Li QC, Chung JH, Rosenthal JL, Winestone LE, Muffly L, Malogolowkin MH, Alvarez EM. Treatment-related toxicities associated with hospitalization in children, adolescents, and young adults with acute lymphoblastic leukemia: population level analysis. Leuk Lymphoma. 2022 Dec; 63(13):3191-3199.  View on PubMed
  7. Miller TP, Getz KD, Li Y, Demissei BG, Adamson PC, Alonzo TA, Burrows E, Cao L, Castellino SM, Daves MH, Fisher BT, Gerbing R, Grundmeier RW, Krause EM, Lee J, Lupo PJ, Rabin KR, Ramos M, Scheurer ME, Wilkes JJ, Winestone LE, Hawkins DS, Gramatges MM, Aplenc R. Rates of laboratory adverse events by course in paediatric leukaemia ascertained with automated electronic health record extraction: a retrospective cohort study from the Children's Oncology Group. Lancet Haematol. 2022 Sep; 9(9):e678-e688.  View on PubMed
  8. Bhatt NS, Sharma A, St Martin A, Abid MB, Brown VI, Diaz Perez MA, Frangoul H, Gadalla SM, Herr MM, Krem MM, Lazarus HM, Martens MJ, Mehta PA, Nishihori T, Prestidge T, Pulsipher MA, Rangarajan HG, Williams KM, Winestone LE, Yin DE, Riches ML, Dandoy CE, Auletta JJ. Clinical Characteristics and Outcomes of COVID-19 in Pediatric and Early Adolescent and Young Adult Hematopoietic Stem Cell Transplant Recipients: A Cohort Study. Transplant Cell Ther. 2022 10; 28(10):696.e1-696.e7.  View on PubMed
  9. Panayiotis Vandris, Karen Chao, Christina Baggott, Christine L. Phillips, Muna Qayed, Jenna Rossoff, Stephanie J. Si Lim, Lena E. Winestone, Heather E. Stefanski, Julie-An M. Talano, Steven Margossian, Michael R. Verneris, Gary Douglas Myers, Nicole A. Karras, Patrick A. Brown, Prakash Satwani, Crystal Mackall, Kevin J. Curran, Theodore Willis Laetsch, Liora M. Schultz. Outcomes of Hispanic and non-Hispanic white pediatric and young adult patients with B-cell acute lymphoblastic leukemia after commercial tisagenlecleucel. Journal of Clinical Oncology. 2022 Jun 1; 40(16_suppl):10016-10016.  View on PubMed
  10. Ding L, Szymczak JE, Evans E, Canepa E, Martin AE, Contractor F, Aplenc R, Joseph G, Winestone LE. Factors that contribute to disparities in time to acute leukemia diagnosis in young people: an in depth qualitative interview study. BMC Cancer. 2022 May 12; 22(1):531.  View on PubMed
  11. Winestone LE. Naming racism: the first step. Blood. 2022 04 07; 139(14):2098-2099.  View on PubMed
  12. Higham CS, Shimano KA, Melton A, Kharbanda S, Chu J, Dara J, Winestone LE, Hermiston ML, Huang JN, Dvorak CC. A pilot trial of prophylactic defibrotide to prevent serious thrombotic microangiopathy in high-risk pediatric patients. Pediatr Blood Cancer. 2022 05; 69(5):e29641.  View on PubMed
  13. Wieduwilt MJ, Metheny L, Zhang MJ, Wang HL, Estrada-Merly N, Marks DI, Al-Homsi AS, Muffly L, Chao N, Rizzieri D, Gale RP, Gadalla SM, Cairo M, Mussetti A, Gore S, Bhatt VR, Patel SS, Michelis FV, Inamoto Y, Badawy SM, Copelan E, Palmisiano N, Kharfan-Dabaja MA, Lazarus HM, Ganguly S, Bredeson C, Diaz Perez MA, Cassaday R, Savani BN, Ballen K, Martino R, Wirk B, Bacher U, Aljurf M, Bashey A, Murthy HS, Yared JA, Aldoss I, Farhadfar N, Liu H, Abdel-Azim H, Waller EK, Solh M, Seftel MD, van der Poel M, Grunwald MR, Liesveld JL, Kamble RT, McGuirk J, Munker R, Cahn JY, Lee JW, Freytes CO, Krem MM, Winestone LE, Gergis U, Nathan S, Olsson RF, Verdonck LF, Sharma A, Ringdén O, Friend BD, Cerny J, Choe H, Chhabra S, Nishihori T, Seo S, George B, Baxter-Lowe LA, Hildebrandt GC, de Lima M, Litzow M, Kebriaei P, Hourigan CS, Abid MB, Weisdorf DJ, Saber W. Haploidentical vs sibling, unrelated, or cord blood hematopoietic cell transplantation for acute lymphoblastic leukemia. Blood Adv. 2022 01 11; 6(1):339-357.  View on PubMed
  14. Forlanini F, Zinter MS, Dvorak CC, Bailey-Olson M, Winestone LE, Shimano KA, Higham CS, Melton A, Chu J, Kharbanda S. Hematopoietic Cell Transplantation-Comorbidity Index Score Is Correlated with Treatment-Related Mortality and Overall Survival following Second Allogeneic Hematopoietic Cell Transplantation in Children. Transplant Cell Ther. 2022 03; 28(3):155.e1-155.e8.  View on PubMed
  15. Anurekha G. Hall, Lena E. Winestone, Erin M. Sullivan, Qian Vicky Wu, Adam J. Lamble, Mark C. Walters, Paibel Aguayo-Hiraldo, Lourdes Baez Conde, Tumaini R. Coker, Hema Dave, Dana Dornsife, Amy K. Keating, Diana M. Merino, Bonnie Ramsey, Julie R. Park, Anurag K. Agrawal. Access to CAR-T Cell Therapy in Underrepresented Populations: A Multicenter Cohort Study of Pediatric and Young Adult ALL Patients. Blood. 2021 Nov 5; 138(Supplement 1):339-339.  View on PubMed
  16. Sumit Gupta, David T. Teachey, Meenakshi Devidas, Yunfeng Dai, Richard Aplenc, Lena Winestone, Kira O Bona, Karen R Rabin, Patrick A Zweidler-McKay, Kelly W Maloney, Leonard A. Mattano, Eric C Larsen, Anne L Angiolillo, Reuven J Schore, Michael J. Burke, Wanda L Salzer, Stuart S. Winter, Kimberly P. Dunsmore, Naomi J Winick, William L. Carroll, Stephen P Hunger, Mignon L. Loh. Racial, Ethnic, and Socioeconomic Factors Result in Disparities in Outcome Among Children with Acute Lymphoblastic Leukemia Not Fully Attenuated By Disease Prognosticators: A Children's Oncology Group (COG) Study. Blood. 2021 Nov 5; 138(Supplement 1):211-211.  View on PubMed
  17. Wolfson JA, Bhatia S, Ginsberg JP, Becker L, Bernstein D, Henk HJ, Lyman GH, Nathan PC, Puccetti D, Wilkes JJ, Winestone LE, Kenzik KM. Expenditures in Young Adults with Hodgkin Lymphoma: NCI-Designated Comprehensive Cancer Centers versus Other Sites. Cancer Epidemiol Biomarkers Prev. 2022 01; 31(1):142-149.  View on PubMed
  18. Dandoy CE, Davies SM, Woo Ahn K, He Y, Kolb AE, Levine J, Bo-Subait S, Abdel-Azim H, Bhatt N, Chewning J, Gadalla S, Gloude N, Hayashi R, Lalefar NR, Law J, MacMillan M, O'Brien T, Prestidge T, Sharma A, Shaw P, Winestone L, Eapen M. Comparison of total body irradiation versus non-total body irradiation containing regimens for de novo acute myeloid leukemia in children. Haematologica. 2021 07 01; 106(7):1839-1845.  View on PubMed
  19. Alvarez E, Le T, Kahn J, Winestone L, Li Q, Keegan T. Comorbidities and socioeconomic status are predictors of survival in children and young adults with Burkitt lymphoma. Leuk Lymphoma. 2021 11; 62(11):2804-2807.  View on PubMed
  20. Aristizabal P, Winestone LE, Umaretiya P, Bona K. Disparities in Pediatric Oncology: The 21st Century Opportunity to Improve Outcomes for Children and Adolescents With Cancer. Am Soc Clin Oncol Educ Book. 2021 Jun; 41:e315-e326.  View on PubMed

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