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 - January 20, 2021 - Barriers to Care Questionnaire for Pediatric Patients with Leukemia, Principal Investigator. Sponsor: American Society of Hematology, Sponsor Award ID:
  • June 15, 2020 - January 20, 2021 - Work Flexibility and Financial Impact Among Families of Children with Cancer, Supervisor. Sponsor: UCSF Clinical & Translational Science Institute, Sponsor Award ID:
  • February 1, 2020 - January 20, 2021 - Access to MIBG Therapy for High Risk Neuroblastoma Patients, Principal Investigator. Sponsor: American Cancer Society, Sponsor Award ID:
  • December 1, 2018 - January 20, 2021 - 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. Forlanini F, Zinter MS, Dvorak CC, Bailey-Olson M, Winestone LE, Shimano KA, Higham CS, Melton A, Chu J, Kharbanda S. Hematopoietic Cell Transplant-Comorbidity Index Score is Correlated with Treatment Related Mortality and Overall Survival following Second Allogeneic Hematopoietic Cell Transplant in Children. Transplant Cell Ther. 2021 Nov 27.  View on PubMed
  2. 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
  3. 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
  4. 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 vs. Other Sites. Cancer Epidemiol Biomarkers Prev. 2021 Nov 04.  View on PubMed
  5. Wieduwilt MJ, Metheny L, Zhang MJ, Wang HL, Estrada-Merly N, Marks DI, Al-Homsi AS, Muffly L, Chao NJ, Rizzieri D, Gale RP, Gadalla SM, Cairo MS, Mussetti A, Gore SD, Bhatt VR, Patel SS, Michelis FV, Inamoto Y, Badawy SM, Copelan E, Palmisiano N, Kharfan-Dabaja MA, Lazarus HM, Ganguly S, Bredeson CN, Diaz Perez MA, Cassaday R, Savani BN, Ballen KK, 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 M, van der Poel MWM, Grunwald MR, Liesveld JL, Kamble RT, McGuirk JP, Munker R, Cahn JY, Lee JW, Freytes CO, Krem M, Winestone LE, Gergis U, Nathan S, Olsson RF, Verdonck LF, Sharma A, Ringden O, Friend BD, Cerny J, Choe HK, Chhabra S, Nishihori T, Seo S, George B, Baxter-Lowe LA, Hildebrandt GC, de Lima M, Litzow MR, 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. 2021 Sep 21.  View on PubMed
  6. 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
  7. 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 Jun 01; 1-7.  View on PubMed
  8. 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
  9. Abrahão R, Huynh JC, Benjamin DJ, Li QW, Winestone LE, Muffly L, Keegan THM. Chronic medical conditions and late effects after acute myeloid leukaemia in adolescents and young adults: a population-based study. Int J Epidemiol. 2021 05 17; 50(2):663-674.  View on PubMed
  10. Higham CS, Collins G, Shimano KA, Melton A, Kharbanda S, Winestone LE, Huang JN, Dara J, Long-Boyle JR, Dvorak CC. Transplant-associated thrombotic microangiopathy in pediatric patients: pre-HSCT risk stratification and prophylaxis. Blood Adv. 2021 04 27; 5(8):2106-2114.  View on PubMed
  11. Ibrahimova A, Winestone LE, Miller TP, Kettler K, Seif AE, Huang YS, Elgarten CW, Myers RM, Fisher BT, Aplenc R, Getz KD. Presentation acuity, induction mortality, and resource utilization in infants with acute leukemia. Pediatr Blood Cancer. 2021 Jul; 68(7):e28940.  View on PubMed
  12. Bona K, Li Y, Winestone LE, Getz KD, Huang YS, Fisher BT, Desai AV, Richardson T, Hall M, Naranjo A, Henderson TO, Aplenc R, Bagatell R. Poverty and Targeted Immunotherapy: Survival in Children's Oncology Group Clinical Trials for High-Risk Neuroblastoma. J Natl Cancer Inst. 2021 03 01; 113(3):282-291.  View on PubMed
  13. Wolfson JA, Bhatia S, Ginsberg J, Becker LK, Bernstein D, Henk HJ, Lyman GH, Nathan PC, Puccetti D, Wilkes JJ, Winestone LE, Kenzik KM. Expenditures among young adults with acute lymphoblastic leukemia by site of care. Cancer. 2021 Jun 01; 127(11):1901-1911.  View on PubMed
  14. Chow EJ, Doody DR, Wilkes JJ, Becker LK, Chennupati S, Morin PE, Winestone LE, Henk HJ, Lyman GH. Adverse events among chronic myelogenous leukemia patients treated with tyrosine kinase inhibitors: a real-world analysis of health plan enrollees. Leuk Lymphoma. 2021 05; 62(5):1203-1210.  View on PubMed
  15. Christine S Higham, Alexis Melton, Sandhya Kharbanda, Jasmeen Dara, Lena E. Winestone, James N Huang, Kristin A. Shimano. A Pilot Trial of Pre-Transplant Risk Stratification and Prophylactic Defibrotide to Prevent Serious Thrombotic Microangiopathy in High-Risk Pediatric Hematopoietic Stem Cell Transplant Patients. Blood. 2020 Nov 5; 136(Supplement 1):9-10.  View on PubMed
  16. Lena E. Winestone, Qian Li, Lori S. Muffly, Kelly D Getz, Elysia Alvarez, Ted Wun, Theresa Keegan. Disparities in the Use of Allogeneic Hematopoietic Stem Cell Transplant Among Children, Adolescents, and Young Adults with Acute Leukemia in California. Blood. 2020 Nov 5; 136(Supplement 1):4-5.  View on PubMed
  17. Winestone LE, Hochman LL, Sharpe JE, Alvarez E, Becker L, Chow EJ, Reiter JG, Ginsberg JP, Silber JH. Impact of Dependent Coverage Provision of the Affordable Care Act on Insurance Continuity for Adolescents and Young Adults With Cancer. JCO Oncol Pract. 2021 06; 17(6):e882-e890.  View on PubMed
  18. Wilkes JJ, Lyman GH, Doody DR, Chennupati S, Becker LK, Morin PE, Winestone LE, Henk HJ, Chow EJ. Health Care Cost Associated With Contemporary Chronic Myelogenous Leukemia Therapy Compared With That of Other Hematologic Malignancies. JCO Oncol Pract. 2021 03; 17(3):e406-e415.  View on PubMed
  19. Cahen VC, Li Y, Getz KD, Elgarten CW, DiNofia AM, Wilkes JJ, Winestone LE, Huang YV, Miller TP, Gramatges MM, Rabin KR, Fisher BT, Aplenc R, Seif AE. Identifying relapses and stem cell transplants in pediatric acute lymphoblastic leukemia using administrative data: Capturing national outcomes irrespective of trial enrollment. Pediatr Blood Cancer. 2021 Sep; 68(9):e28315.  View on PubMed
  20. Penumarthy NL, Goldsby RE, Shiboski SC, Wustrack R, Murphy P, Winestone LE. Insurance impacts survival for children, adolescents, and young adults with bone and soft tissue sarcomas. Cancer Med. 2020 02; 9(3):951-958.  View on PubMed

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