Photo of Kira Bona,  MD, MPH

Kira Bona, MD, MPH

Dana-Farber Cancer Institute

Dana-Farber Cancer Institute
Phone: (617) 632-4688
Fax: (617) 632-4410


kira.bona@childrens.harvard.edu

Kira Bona, MD, MPH

Dana-Farber Cancer Institute

EDUCATIONAL TITLES

  • Instructor, Pediatrics, Harvard Medical School
  • Attending Physician Pediatric Hematology/Oncology, Medicine, Boston Children's Hospital
  • Attending Physician Pediatric Hematology/Oncology, Pediatric Oncology, Dana-Farber Cancer Institute

DF/HCC PROGRAM AFFILIATION

Research Abstract

I am a pediatric oncologist and investigator focused on improving disease outcomes for pediatric cancer patients by systematically intervening on social determinants of health. One in five children in the United States lives in poverty. Emerging evidence demonstrates that despite highly protocolized care, poverty-related outcome disparities exist in childhood cancer in the United States. The mechanisms underlying this relationship have not been defined, nor have modifiable domains of poverty been investigated. My research agenda frames this disparity as an opportunity to improve residual morbidity and mortality in pediatric cancer by systematically considering poverty as a risk factor for poor outcome and integrating it into the existing robust clinical trial model of discovery and care in pediatric cancer. I have formal training in health services and outcomes research, and clinical expertise in pediatric oncology with a specific focus on hematological malignancies. As an early career investigator I have developed content expertise in the areas of financial hardship and measures of poverty in pediatrics. My work to date has demonstrated an association between community-level poverty and higher risk of early relapse in children with acute lymphoblastic leukemia (ALL). I have additionally identified a high rate of a remediable measure of poverty (household material hardship (HMH)) in the pediatric oncology clinical setting. I am currently conducting an embedded investigation of HMH to investigate the impact of poverty on relapse, overall survival and chemotherapy adherence in the context of a multicenter therapeutic clinical trial for pediatric ALL (DFCI 16-001). These data will lay the groundwork for future research testing poverty-targeted interventions in the pediatric clinical trial setting. My career goal is to reduce residual morbidity and mortality in pediatric cancer through the design of interventions targeting poverty as a determinant of child health outcomes.

Publications

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  • Abel GA, Albelda R, Khera N, Hahn T, Salas Coronado DY, Odejide OO, Bona K, Tucker-Seeley R, Soiffer R. Financial Hardship and Patient-Reported Outcomes after Hematopoietic Cell Transplantation. Biol Blood Marrow Transplant 2016. PubMed
  • Bona K, Blonquist TM, Neuberg DS, Silverman LB, Wolfe J. Impact of Socioeconomic Status on Timing of Relapse and Overall Survival for Children Treated on Dana-Farber Cancer Institute ALL Consortium Protocols (2000-2010). Pediatr Blood Cancer 2016; 63:1012-8. PubMed
  • Pelletier W, Bona K. Assessment of Financial Burden as a Standard of Care in Pediatric Oncology. Pediatr Blood Cancer 2015; 62 Suppl 5:S619-31. PubMed
  • Bona K, London WB, Guo D, Frank DA, Wolfe J. Trajectory of Material Hardship and Income Poverty in Families of Children Undergoing Chemotherapy: A Prospective Cohort Study. Pediatr Blood Cancer 2015. PubMed
  • Bona K, London WB, Guo D, Abel G, Lehmann L, Wolfe J. Prevalence and impact of financial hardship among New England pediatric stem cell transplantation families. Biol Blood Marrow Transplant 2015; 21:312-8. PubMed
  • Bona K, Dussel V, Orellana L, Kang T, Geyer R, Feudtner C, Wolfe J. Economic impact of advanced pediatric cancer on families. J Pain Symptom Manage 2014; 47:594-603. PubMed
  • Bona K, Bates J, Wolfe J. Massachusetts' Pediatric Palliative Care Network: successful implementation of a novel state-funded pediatric palliative care program. J Palliat Med 2011. PubMed
  • Dussel V, Bona K, Heath JA, Hilden JM, Weeks JC, Wolfe J. Unmeasured costs of a child's death: perceived financial burden, work disruptions, and economic coping strategies used by American and Australian families who lost children to cancer. J Clin Oncol 2011; 29:1007-13. PubMed
  • Neuner JM, Hamel MB, Phillips RS, Bona K, Aronson MD. Diagnosis and management of adults with pharyngitis. A cost-effectiveness analysis. Ann Intern Med 2003; 139:113-22. PubMed