Lena Winestone, MD

Assistant Adjunct Professor
Pediatrics
+1 415 476-2188

My research explores racial, ethnic, and socioeconomic disparities in access to care and outcome of leukemia and lymphoma treatment. I study access to care across the continuum of pediatric cancer from diagnosis and clinical trial enrollment through treatment and relapse to salvage therapies. My 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. My ongoing work investigates access to highly specialized and complex therapies such as stem cell transplant, chimeric antigen receptor T cells, and MIBG therapy.

Publications: 

Health Care Cost Associated With Contemporary Chronic Myelogenous Leukemia Therapy Compared With That of Other Hematologic Malignancies.

JCO oncology practice

Wilkes JJ, Lyman GH, Doody DR, Chennupati S, Becker LK, Morin PE, Winestone LE, Henk HJ, Chow EJ

Comparison of total body irradiation versus non- total body irradiation containing regimens for de novo acute myeloid leukemia in children.

Haematologica

Dandoy CE, Davies SM, Ahn KW, He Y, Kolb AE, Levine J, Bo-Subait S, Abdel-Azim H, Bhatt N, Chewing 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

Health plan expenditures young adults with newly-diagnosed Hodgkin lymphoma (HL) by care at NCI-designated comprehensive cancer centers (CCC) vs. other treatment sites (non-CCC).

Journal of Clinical Oncology

Julie Anna Wolfson, Smita Bhatia, Jill P. Ginsberg, Laura Becker, David Bernstein, Henry J. Henk, Gary H. Lyman, Paul C. Nathan, Diane Puccetti, Jennifer J Wilkes, Lena Winestone, Kelly Kenzik

Identifying relapses and stem cell transplants in pediatric acute lymphoblastic leukemia using administrative data: Capturing national outcomes irrespective of trial enrollment.

Pediatric blood & cancer

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

Insurance impacts survival for children, adolescents, and young adults with bone and soft tissue sarcomas.

Cancer medicine

Penumarthy NL, Goldsby RE, Shiboski SC, Wustrack R, Murphy P, Winestone LE

The impact of total body irradiation-based regimens on outcomes in children and young adults with acute lymphoblastic leukemia undergoing allogeneic hematopoietic stem cell transplantation.

Pediatric blood & cancer

Friend BD, Bailey-Olson M, Melton A, Shimano KA, Kharbanda S, Higham C, Winestone LE, Huang J, Stieglitz E, Dvorak CC

Area-Based Socioeconomic Disparities in Survival of Children with Newly Diagnosed Acute Myeloid Leukemia: A Report from the Children's Oncology Group.

Blood

Lena E. Winestone, Kelly D Getz, Kira O Bona, Brian T. Fisher, Alan S Gamis, Alix E. Seif, Lillian Sung, Yi-Cheng Wang, Todd A. Alonzo, Richard Aplenc

Rates of Laboratory Adverse Events By Chemotherapy Course for Pediatric Acute Leukemia Patients within the Leukemia Electronic Abstraction of Records Network (LEARN).

Blood

Tamara P. Miller, Kelly D Getz, Biniyam Demissei, Karen R. Rabin, Marla Daves, Philip J. Lupo, Michael E. Scheurer, Evanette Burrows, Brian T. Fisher, Robert W. Grundmeier, Judy Lee, Jennifer J. Wilkes, Lena E. Winestone, Maria Monica J. Gramatges, Richard Aplenc

Disparities in Survival and Health Outcomes in Childhood Leukemia.

Current hematologic malignancy reports

Winestone LE, Aplenc R

Factors impacting time to diagnosis in pediatric, adolescent and young adult (AYA) patients with solid tumors.

Journal of Clinical Oncology

Elysia Marie Alvarez, Lena Winestone, Jeffrey McPheeters, Diane Puccetti, Jennifer Jill Wilkes, Henry J. Henk, Smita Bhatia, Jill P. Ginsberg, Theresa Keegan, Brad H. Pollock

Disparities in pediatric acute myeloid leukemia (AML) clinical trial enrollment.

Leukemia & lymphoma

Winestone LE, Getz KD, Rao P, Li Y, Hall M, Huang YV, Seif AE, Fisher BT, Aplenc R

Hematopoietic Cell Transplantation in Young Adult Acute Lymphoblastic Leukemia: A United States Population-Level Analysis.

Journal of adolescent and young adult oncology

Muffly L, Li Q, Alvarez E, Kahn J, Winestone L, Cress R, Penn DC, Keegan THM

Renal Complications Associated with HSCT.

Hematopoietic Stem Cell Transplantation for the Pediatric Hematologist/Oncologist

Lena E. Winestone, Alix E. Seif, Benjamin L. Laskin

High human herpesvirus 6 viral load in pediatric allogeneic hematopoietic stem cell transplant patients is associated with detection in end organs and high mortality.

Pediatric transplantation

Winestone LE, Punn R, Tamaresis JS, Buckingham J, Pinsky BA, Waggoner JJ, Kharbanda S

Complications preceding early deaths in Black and White children with acute myeloid leukemia.

Pediatric blood & cancer

Winestone LE, Getz KD, Miller TP, Li Y, Huang YS, Seif AE, Fisher BT, Aplenc R

Recurrent Donath-Landsteiner hemolytic anemia: a pediatric case report.

Transfusion

Prince SD, Winestone LE, Nance SJ, Friedman DF

The role of acuity of illness at presentation in early mortality in black children with acute myeloid leukemia.

American journal of hematology

Winestone LE, Getz KD, Miller TP, Wilkes JJ, Sack L, Li Y, Huang YS, Seif AE, Bagatell R, Fisher BT, Epstein AJ, Aplenc R

Increased utilization of pediatric specialty care: a population study of pediatric oncology inpatients in California.

Journal of pediatric hematology/oncology

Chamberlain LJ, Pineda N, Winestone L, Saynina O, Rangaswami A, Link M, Wise PH

Immune reconstitution following autologous transfers of CD3/CD28 stimulated CD4(+) T cells to HIV-infected persons.

Clinical immunology (Orlando, Fla.)

Bernstein WB, Cox JH, Aronson NE, Tracy L, Schlienger K, Ratto-Kim S, Garner R, Cotte J, Zheng Z, Winestone L, Liebig C, Galley LM, Connors M, Birx DL, Carroll RG, Levine BL