Lena Winestone, MD
Assistant Professor
Pediatrics
School of Medicine

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.

• Trends in Volumes and Survival After Hematopoietic Cell Transplantation in Racial/Ethnic Minorities.
  Blood advances 2024 Khera N, Ailawadhi S, Brazauskas R, Patel J, Jacobs B, Ustun C, Ballen K, Abid MB, Díaz MA, Al-Homsi AS, Hashem H, Hong S, Munker R, Schears R, Lazarus HM, Ciurea SO, Badawy SM, Savani BN, Wirk B, …
• Diagnosing and Grading of Sinusoidal Obstructive Syndrome after Hematopoietic Stem Cell Transplant of Children, Adolescent and Young Adults treated in a Pediatric Institution with Pediatric Protocols.
  Transplantation and cellular therapy 2024 Cisneros GS, Dvorak CC, Long-Boyle J, Kharbanda S, Shimano KA, Melton A, Chu J, Winestone LE, Dara J, Huang JN, Hermiston ML, Zinter M, Higham CS
• Intensive care risk and long-term outcomes in pediatric allogeneic hematopoietic cell transplant recipients.
  Blood advances 2024 Zinter MS, Brazauskas R, Strom J, Chen S, Bo-Subait S, Sharma A, Beitinjaneh A, Dimitrova D, Guilcher G, Preussler J, Myers K, Bhatt NS, Ringden O, Hematti P, Hayashi RJ, Patel S, De Oliveira SN, Rotz…
• Establishing Costs for Commercial Chimeric Antigen Receptor T-Cell (Tisagenlecleucel; Kymriah) in Children and Young Adult B-Cell Acute Lymphoblastic Leukemia: A Merged Analysis from the Pediatric Real-World CAR Consortium (PRWCC) and Pediatric Health Information System (PHIS).
  Transplantation and Cellular Therapy 2024 Prakash Satwani, Karen Chao, Maria Lopez-Garcia, Matt Hall, Zhezhen Jin, Lena E. Winestone, Danielle Friedman, Rachel Phelan, Christina Baggott, Samuel John, Holly L Pacenta, Theodore W Laetsch, …
• Financial assistance and other financial coping strategies after a pediatric cancer diagnosis.
  Pediatric blood & cancer 2024 Lin JJ, Evans EM, Praxedes K, Agrawal AK, Winestone LE
• Pre- and Postnatal Exposures to Tobacco Smoking and Survival of Childhood Acute Lymphoblastic and Myeloid Leukemias in California, United States.
  Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology 2024 Metayer C, Morimoto LM, Kang AY, Sanchez Alvarez J, Winestone LE
• Distance to Care Predicts Clinical Trial Enrollment on COG ALL Clinical Trials: A Report from the Children's Oncology Group.
  Blood 2023 Lena E Winestone, Sumit Gupta, Jeannette Sample, David Van Riper, Katherine Knowles, Zhiguo Chen, Bo Jiang, Maria C Velez, Mignon L. Loh, Philip J. Lupo, Naomi J Winick, Erin Marcotte
• Unfavorable transcriptome profiles and social disadvantage in hematopoietic cell transplantation: a CIBMTR analysis.
  Blood advances 2023 Taylor MR, Cole SW, Strom J, Brazauskas R, Baker KS, Phelan R, Buchbinder D, Hamilton B, Schoemans H, Shaw BE, Sharma A, Bhatt NS, Badawy SM, Winestone LE, Preussler JM, Mayo S, Jamani K, Nishihori T,…
• Association of the social disorganization index with time to first septic shock event in children with acute myeloid leukemia.
  Cancer 2023 Ruiz J, Li Y, Cao L, Huang YV, Tam V, Griffis HM, Winestone LE, Fisher BT, Alonzo TA, Wang YJ, Dang AT, Kolb EA, Glanz K, Getz KD, Aplenc R, Seif AE
• Racial and ethnic disparities in acuity of presentation among children with newly diagnosed acute leukemia.
  Pediatric blood & cancer 2023 Winestone LE, Getz KD, Li Y, Burrows E, Scheurer ME, Tam V, Gramatges MM, Wilkes JJ, Miller TP, Seif AE, Rabin KR, Fisher BT, Aplenc R
• Practice Preferences for Consolidative Hematopoietic Stem Cell Transplantation Following Tisagenlecleucel in Children and Young Adults with B Cell Acute Lymphoblastic Leukemia.
  Transplantation and cellular therapy 2023 McNerney KO, Moskop A, Winestone LE, Baggott C, Talano JA, Schiff D, Rossoff J, Modi A, Verneris MR, Laetsch TW, Schultz L
• Critical Illness Risk and Long-Term Outcomes Following Intensive Care in Pediatric Hematopoietic Cell Transplant Recipients.
  medRxiv : the preprint server for health sciences 2023 Zinter MS, Brazauskas R, Strom J, Chen S, Bo-Subait S, Sharma A, Beitinjaneh A, Dimitrova D, Guilcher G, Preussler J, Myers K, Bhatt NS, Ringden O, Hematti P, Hayashi RJ, Patel S, De Oliveira SN, Rotz…
• Subspecialty Pediatrics: An Unmet Opportunity to Address Unmet Social Risks.
  Academic pediatrics 2023 Wadhwani SI, Pantell MS, Winestone LE
• Racial and Socioeconomic Disparities in Long-Term Outcomes in ≥1 Year Allogeneic Hematopoietic Cell Transplantation Survivors: A CIBMTR Analysis.
  Transplantation and cellular therapy 2023 Blue BJ, Brazauskas R, Chen K, Patel J, Zeidan AM, Steinberg A, Ballen K, Kwok J, Rotz SJ, Perez MAD, Kelkar AH, Ganguly S, Wingard JR, Lad D, Sharma A, Badawy SM, Lazarus HM, Hashem H, Szwajcer D, …
• Feasibility and acceptability of social determinants of health data collection in the context of a Children’s Oncology Group trial.
  Journal of Clinical Oncology 2023 Emily Jones, Arlene Naranjo, Lena E. Winestone, Puja J Umaretiya, Rahela Aziz-Bose, Lenka Anne Skaidrite Ilcisin, Emily Gustava Greengard, Steven G. DuBois, Rochelle Bagatell, Kira Bona
• Racial and Ethnic Disparities in Outcomes following Hematopoietic Stem Cell Transplant (HCT) in Patients with Severe Combined Immunodeficiency (SCID).
  Clinical Immunology 2023 Lena Winestone, Brent R. Logan, Xuerong Liu, Rebecca H. Buckley, Richard J O’Reilly, Linda M. Griffith, Jennifer Puck, Christopher C. Dvorak, Morton J Cowan, Elie Haddad
• Access to Chimeric Antigen Receptor T Cell Clinical Trials in Underrepresented Populations: A Multicenter Cohort Study of Pediatric and Young Adult Acute Lymphobastic Leukemia Patients.
  Transplantation and cellular therapy 2023 Hall AG, Winestone LE, Sullivan EM, Wu Q, Lamble AJ, Walters MC, Aguayo-Hiraldo P, Baez Conde L, Coker TR, Dornsife D, Keating AK, Merino DM, Ramsey B, Park JR, Agrawal AK
• Ethnic disparities in childhood leukemia survival by border residence: A Texas population-based analysis.
  Cancer 2023 Castellanos MI, Oluyomi AO, Chambers TM, Gramatges MM, Winestone LE, Lupo PJ, Scheurer ME
• Impact of poverty and neighborhood opportunity on outcomes for children treated with CD19-directed CAR T-cell therapy.
  Blood 2023 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 KD, Aplenc R, Teachey DT, Maude SL, Grupp SA…
• 345 Prophylactic Tocilizumab Decreases Incidence of Acute Graft-Versus-Host Disease Following Alpha/Beta T-Cell Depleted Haploidentical Hematopoietic Stem Cell Transplantation in Children and Young Adults.
  Transplantation and Cellular Therapy 2023 Soohee Cho, Christopher C. Dvorak, Christine S. Higham, Gabriel Salinas Cisneros, Julia Chu, Alexis Melton, Lena E. Winestone, Kristin A. Shimano, Jasmeen Dara, Michelle Hermiston, James N. Huang, …
• Racial and ethnic disparities in childhood and young adult acute lymphocytic leukaemia: secondary analyses of eight Children's Oncology Group cohort trials.
  The Lancet. Haematology 2023 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, …
• Data standards in pediatric oncology: Past, present, and future.
  Pediatric blood & cancer 2022 Wyatt KD, Noyd DH, Wood NM, Phillips CA, Miller TP, Rubin EM, Winestone LE, Waanders AJ, Perentesis JP, Aplenc R
• High Incidence and Mortality of Invasive Fungal Disease in Children and Young Adults with Hematologic Malignancies in Hawaii and Pacific Islands.
  Blood 2022 Chattip Prueksapraopong, Trevor Hirata, Lauryn Liao, Kyle Ishikawa, John J. Chen, Wade Kyono, Darryl W. Glaser, Randal Wada, Rodolfo Bégué, Brian T. Fisher, Lena E. Winestone, Kelley C. Okimoto, …
• The Influence of Genetic Ancestry on Disease Biology in Pediatric T-Cell Acute Lymphoblastic Leukemia.
  Blood 2022 Haley Newman, Shawn Lee, Petri Pölönen, Rawan Shraim, Yimei Li, Hongyan Liu, Tiffaney L. Vincent, Richard Aplenc, Changya Chen, Zhiguo Chen, Caroline Diorio, Kimberly P. Dunsmore, Sumit Gupta, Gang Wu…
• Impact of pre-transplant induction and consolidation cycles on AML allogeneic transplant outcomes: a CIBMTR analysis in 3113 AML patients.
  Leukemia 2022 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, …
• Leveraging Clinical Trial Populations and Data from the Children's Oncology Group for Cancer Survivorship Research.
  Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology 2022 Chow EJ, Winestone LE, Lupo PJ, Diller LR, Henderson TO, Kadan-Lottick NS, Levine JM, Ness KK, Bhatia S, Armenian SH
• Treatment-related toxicities associated with hospitalization in children, adolescents, and young adults with acute lymphoblastic leukemia: population level analysis.
  Leukemia & lymphoma 2022 Namjoshi NS, Keegan THM, Li QC, Chung JH, Rosenthal JL, Winestone LE, Muffly L, Malogolowkin MH, Alvarez EM
• 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.
  The Lancet. Haematology 2022 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,…
• Clinical Characteristics and Outcomes of COVID-19 in Pediatric and Early Adolescent and Young Adult Hematopoietic Stem Cell Transplant Recipients: A Cohort Study.
  Transplantation and cellular therapy 2022 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, …
• 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 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…
• Factors that contribute to disparities in time to acute leukemia diagnosis in young people: an in depth qualitative interview study.
  BMC cancer 2022 Ding L, Szymczak JE, Evans E, Canepa E, Martin AE, Contractor F, Aplenc R, Joseph G, Winestone LE
• A pilot trial of prophylactic defibrotide to prevent serious thrombotic microangiopathy in high-risk pediatric patients.
  Pediatric blood & cancer 2022 Higham CS, Shimano KA, Melton A, Kharbanda S, Chu J, Dara J, Winestone LE, Hermiston ML, Huang JN, Dvorak CC
• Haploidentical vs sibling, unrelated, or cord blood hematopoietic cell transplantation for acute lymphoblastic leukemia.
  Blood advances 2022 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, …
• Hematopoietic Cell Transplantation-Comorbidity Index Score Is Correlated with Treatment-Related Mortality and Overall Survival following Second Allogeneic Hematopoietic Cell Transplantation in Children.
  Transplantation and cellular therapy 2021 Forlanini F, Zinter MS, Dvorak CC, Bailey-Olson M, Winestone LE, Shimano KA, Higham CS, Melton A, Chu J, Kharbanda S
• Expenditures in Young Adults with Hodgkin Lymphoma: NCI-Designated Comprehensive Cancer Centers versus Other Sites.
  Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology 2021 Wolfson JA, Bhatia S, Ginsberg JP, Becker L, Bernstein D, Henk HJ, Lyman GH, Nathan PC, Puccetti D, Wilkes JJ, Winestone LE, Kenzik KM
• Comparison of total body irradiation versus non-total body irradiation containing regimens for de novo acute myeloid leukemia in children.
  Haematologica 2021 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…
• Comorbidities and socioeconomic status are predictors of survival in children and young adults with Burkitt lymphoma.
  Leukemia & lymphoma 2021 Alvarez E, Le T, Kahn J, Winestone L, Li Q, Keegan T
• Disparities in Pediatric Oncology: The 21st Century Opportunity to Improve Outcomes for Children and Adolescents With Cancer.
  American Society of Clinical Oncology educational book. American Society of Clinical Oncology. Annual Meeting 2021 Aristizabal P, Winestone LE, Umaretiya P, Bona K
• Chronic medical conditions and late effects after acute myeloid leukaemia in adolescents and young adults: a population-based study.
  International journal of epidemiology 2021 Abrahão R, Huynh JC, Benjamin DJ, Li QW, Winestone LE, Muffly L, Keegan THM
• Transplant-associated thrombotic microangiopathy in pediatric patients: pre-HSCT risk stratification and prophylaxis.
  Blood advances 2021 Higham CS, Collins G, Shimano KA, Melton A, Kharbanda S, Winestone LE, Huang JN, Dara J, Long-Boyle JR, Dvorak CC
• Presentation acuity, induction mortality, and resource utilization in infants with acute leukemia.
  Pediatric blood & cancer 2021 Ibrahimova A, Winestone LE, Miller TP, Kettler K, Seif AE, Huang YS, Elgarten CW, Myers RM, Fisher BT, Aplenc R, Getz KD
• Poverty and Targeted Immunotherapy: Survival in Children's Oncology Group Clinical Trials for High-Risk Neuroblastoma.
  Journal of the National Cancer Institute 2021 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
• Expenditures among young adults with acute lymphoblastic leukemia by site of care.
  Cancer 2021 Wolfson JA, Bhatia S, Ginsberg J, Becker LK, Bernstein D, Henk HJ, Lyman GH, Nathan PC, Puccetti D, Wilkes JJ, Winestone LE, Kenzik KM
• Adverse events among chronic myelogenous leukemia patients treated with tyrosine kinase inhibitors: a real-world analysis of health plan enrollees.
  Leukemia & lymphoma 2020 Chow EJ, Doody DR, Wilkes JJ, Becker LK, Chennupati S, Morin PE, Winestone LE, Henk HJ, Lyman GH
• Disparities in the Use of Allogeneic Hematopoietic Stem Cell Transplant Among Children, Adolescents, and Young Adults with Acute Leukemia in California.
  Blood 2020 Lena E. Winestone, Qian Li, Lori S. Muffly, Kelly D Getz, Elysia Alvarez, Ted Wun, Theresa Keegan
• Impact of Dependent Coverage Provision of the Affordable Care Act on Insurance Continuity for Adolescents and Young Adults With Cancer.
  JCO oncology practice 2020 Winestone LE, Hochman LL, Sharpe JE, Alvarez E, Becker L, Chow EJ, Reiter JG, Ginsberg JP, Silber JH
• Health Care Cost Associated With Contemporary Chronic Myelogenous Leukemia Therapy Compared With That of Other Hematologic Malignancies.
  JCO oncology practice 2020 Wilkes JJ, Lyman GH, Doody DR, Chennupati S, Becker LK, Morin PE, Winestone LE, Henk HJ, Chow EJ
• Trend in TKI Use, Adherence, and Switching Patterns in Patients With CML: Before and After the Availability of Generic Imatinib.
  2020 Henry J Henk, Lena E Winestone, Jennifer J Wilkes, Pamela Morin, Shasank Chennupati, David R Doody, Eric J Chow, Gary H Lyman
• Abstract C067: Impact of neighborhood socioeconomic status on survival among young patients with acute leukemia in California.
  Cancer Epidemiology Biomarkers & Prevention 2020 Lena E Winestone, Juan Yang, Daphne Y Lichtensztajn, Renata Abrahao, Theresa H Keegan, Iona Cheng, Scarlett L Gomez, Salma Shariff-Marco
• Identifying relapses and stem cell transplants in pediatric acute lymphoblastic leukemia using administrative data: Capturing national outcomes irrespective of trial enrollment.
  Pediatric blood & cancer 2020 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 2019 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 2019 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 2019 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
• 50 Years Ago in TheJournal ofPediatrics: Fifty-Two Forms of Childhood Cancer, United States Mortality Experience, 1960-1966.
  The Journal of pediatrics 2019 Winestone L, Cabana MD
• Disparities in Survival and Health Outcomes in Childhood Leukemia.
  Current hematologic malignancy reports 2019 Winestone LE, Aplenc R
• Factors impacting time to diagnosis in pediatric, adolescent and young adult (AYA) patients with solid tumors.
  Journal of Clinical Oncology 2019 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
• Hematopoietic Cell Transplantation in Young Adult Acute Lymphoblastic Leukemia: A United States Population-Level Analysis.
  Journal of adolescent and young adult oncology 2019 Muffly L, Li Q, Alvarez E, Kahn J, Winestone L, Cress R, Penn DC, Keegan THM
• Comparable on-therapy mortality and supportive care requirements in Black and White patients following initial induction for pediatric acute myeloid leukemia.
  Pediatric blood & cancer 2018 Li Y, Newton JG, Getz KD, Huang YS, Seif AE, Fisher BT, Aplenc R, Winestone LE
• Renal Complications Associated with HSCT.
  Hematopoietic Stem Cell Transplantation for the Pediatric Hematologist/Oncologist 2018 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 2017 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 2017 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 2017 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 2016 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 2014 Chamberlain LJ, Pineda N, Winestone L, Saynina O, Rangaswami A, Link M, Wise PH
• Acceptability and feasibility of integration of HIV care services into antenatal clinics in rural Kenya: a qualitative provider interview study.
  Global public health 2011 Winestone LE, Bukusi EA, Cohen CR, Kwaro D, Schmidt NC, Turan JM
• Immune reconstitution following autologous transfers of CD3/CD28 stimulated CD4(+) T cells to HIV-infected persons.
  Clinical immunology (Orlando, Fla.) 2004 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