Areas of Expertise:
Endocrine late effects of chemotherapy and radiation, Unrelated-donor and partially matched-related bone marrow transplantation
Locations: Main Campus
Appointments and Referrals: 1-800-TRY-CHOP (1-800-879-2467)
As the director of the Children's Hospital Blood and Marrow Transplant (BMT) Program, I care for patients who will not be cured without a BMT. I also am involved in clinical research to improve outcomes and decrease risks for our transplant patients.
Our bone marrow transplantation program at The Children's Hospital of Philadelphia is one of the largest and oldest pediatric bone marrow transplant programs in the U.S., with more than 1,200 transplants performed. Our program provides the unique combination of comprehensive patient treatment, multidisciplinary teamwork, innovative research and family support. We have 11 beds in HEPA-filtered rooms in a special HEPA-filtered unit which includes a playroom and family lounge. Our physicians, radiation oncologists, nurse practitioners, donor search coordinator, social worker, nutritionists and child life specialists all work together to provide comprehensive care for each patient.
At Children's Hospital, we are expert in everything related to blood and marrow transplants. We have the ability to collect autologous (self) hematopoietic stem cells from very small children for use in high dose chemotherapy protocols. We have expertise in allogeneic transplants, with matched related donors, unrelated donors and cord blood.
We have various clinical studies open. Our research efforts are directed toward providing better outcomes for children who receive bone marrow transplantation. We have developed special protocols to reduce the risks of complications from graft vs. host disease (GVHD) with an unrelated or partially matched related donor, which gives us the ability to use donors other institutions may not be able to use.
Translational research forms an important part of our program. A drug, sirolimus, was found to be effective in killing lymphoid leukemia in the lab of one of our physicians. This drug was added post transplant to patients with leukemia post transplant to improve outcomes. This pilot study was then taken to the Children's Oncology Group, and is now an important randomized protocol which may improve leukemia free survival. We participate with the University of Pennsylvania's Abramson Cancer Center, and studies have been done to show that donor cells activated by a special process and then given to the patient with relapsed leukemia or lymphoma may have a potent anti-cancer effect. These studies are being expanded.
Our program is accredited by the Foundation for Accreditation of Cell Therapy (FACT). All three components -- clinical, cell collection and stem cell laboratory -- are accredited. FACT accreditation is an extremely rigorous process, and there are few pediatric centers that have all three components on site.
- Education and Training
MD - University of Cincinnati College of Medicine, Cincinnati, OH
Pediatrics - Mott Children's Hospital, University of Michigan, Ann Arbor, MI
Hematology/Oncology - St. Jude Children's Research Hospital, Memphis, TN
- Titles and Academic Titles
Professor of Pediatrics, Perelman School of Medicine at the University of Pennsylvania
- Departments and Services
Bunin N, DiDomenico C, Guzikowski V. Hematopoietic stem cell transplantation. In: Schwartz CL, Hobbie WL, Constine LS, Ruccione KS, editors. Survivors of childhood and adolescent cancer: a multidisciplinary approach. 2nd ed. New York: Springer, Berlin Heidelberg; 2005. p. 271-82.
Grupp SA, Stern JW, Bunin N, von Allmen D, Pierson G, Nancarrow CH, et al. In: Berdel WE, Jurgens H, Buchner TH, Ritter J, Kienast J, Vormoor J, editors. Rapid sequence tandem transplant in children with high-risk neuroblastoma. Transplant in Hematology & Oncology II; New York: Springer-Verlag Berlin Heidelberg; 2002. p 270-79.
D'Angio G, Bunin N. Pediatric toxicity. In: John MJ, editor. Chemoradiation: an integrated approach to cancer treatment. Philadelphia: Lea & Febriger; 1993. p. 524-59.
Bunin NJ, Meadows AT. Lymphomas in children. In: Holland JF, et al., editors. Cancer medicine. Philadelphia:Lea & Febriger; 1993. 170;1-11.
Bunin NJ. Non-Hodgkin's lymphoma. In: McAnarney ER, et al, editors. Textbook of adolescent medicine. Philadelphia: W.B. Saunders; 1992. p. 453-58.
Finlay JL, Bunin NJ, Sinniah D. Non-Hodgkin's lymphoma. In: Arnold E, editor. Practical pediatric oncology; 1992. p. 269-76.
Baker DL, Bunin NJ. Germ cell tumors. In: Arnold E, editor. Practical pediatric oncology; 1992. p. 340-44.
Casper JT, Bunin NJ, Truitt R, Camitta B, Ash R. Pediatric bone marrow transplantation utilizing unrelated donors. In: Johnson FL, Pochedly C, editors. Bone marrow transplantation in children. New York: Raven Press; 1989. p. 301-27
Gilman AL, Jacobsen C, Bunin N, Levine J, Goldman F, Bendel A, et al. Phase I study of tandem high-dose chemotherapy with autologous peripheral blood stem cell rescue for children with recurrent brain tumors: a pediatric blood and marrow transplant consortium study. Pediatr Blood Cancer. 2011 Sep;57(3):506-13. doi: 10.1002/pbc.22899. Epub 2010 Dec 1. Cited in Pub Med: PMID 21744474. Read the abstract
Baker KS, Bhatia S, Bunin N, Nieder M, Dvorak CC, Sung L, et al. NCI, NHLBI First International Consensus Conference on Late Effects after Pediatric Hematopoietic Cell Transplantation: State of the Science, Future Directions. Biol Blood Marrow Transplant. Epub 2011 Jun 30. cited in PubMed: PMID 21723224. Read the abstract
Nemecek ER, Ellis K, He W, Bunin NJ, Bajwa RS, Cheerva A, et al. Outcome of myeloablative conditioning and unrelated donor hematopoietic cell transplantation for childhood acute lymphoblastic leukemia in third remission. Biol Blood Marrow Transplant. Epub 2011 May 27. Cited in PubMed: PMID 21683798. Read the abstract
Cable C, Finkel RS, Lehky TJ, Biassou NM, Wiggs EA, Bunin N, et al. Unrelated umbilical cord blood transplant for juvenile metachromatic leukodystrophy: a 5-year follow-up in three affected siblings. Mol Genet Metab. 2011 Feb;102(2)207-9. Epub 2010 Oct 28. Cited in Pub Med: PMID 21035368. Read the abstract
Gilman AL, Jacobsen C, Bunin N, Levine J, Goldman F, Bendel A, et al. Phase I study of tandem high-dose chemotherapy with autologous peripheral blood stem cell rescue for children with recurrent brain tumors: a pediatric blood and marrow transplant consortium study. Pediatr Blood Cancer. 2Epub 010 Dec 1. Cited in PubMed: PMID 21125619. Read the abstract
Cable C, Finkel RS, Lehky TJ, Biassou NM, Wiggs EA, Bunin N, et al. Unrelated umbilical cord blood transplant for juvenile metachromatic leukodystrophy: a 5-year follow-up in three affected siblings. Mol Genet Metab. 2010 Oct 2. Cited in PubMed: PMID 21035368. Read the abstract
Walters MC, Hardy K, Edwards S, Adamkiewicz T, Barkovich J, Bernaudin F, et al. Pulmonary, gonadal, and central nervous system status after bone marrow transplantation for sickle cell disease. Biol Blood Marrow Transplant. 2010 Feb;16(2):263-72. Epub 2009 Oct 12. Cited in PubMed: PMID 19822218. Read abstract
Niemeyer CM, Kang MW, Shin DH, Furlan I, Erlacher M, Bunin NJ, et al. Germline CBL mutations cause developmental abnormalities and predispose to juvenile myelomonocytic leukemia. Nat Genet. 2010 Sep;42(9)794-800. Epub 2010 Aug 8. Cited in PubMed: PMID 20694012. Read the abstract
Bunin N, Guzikowski V, Rand ER, Goldfarb S, Baluarte J, Meyers K, et al. Solid organ transplants following hematopoietic stem cell transplant in children. Pediatr Transplant. 2010 Dec;14(8):1030-5. doi: 10.1111/j.1399-3046.2010.01401.x. pub 2010 Sep 15. Cited in PubMed: PMID 20846242. Read the abstract.
Pulsipher MA, Wall DA, Grimley M, Goyal RK, Boucher KM, Hankins P, et al. A phase I/II study of the safety and efficacy of the addition of sirolimus to tacrolimus/methotrexate graft versus host disease prophylaxis after allogeneic haematopoietic cell transplantation in paediatric acute lymphoblastic leukaemia (ALL). Br J Haematol. 2009 Dec;147(5):691-9. Epub 2009 Sept 10. Cited in PubMed: PMID 19744131. Read the article
Norris R, Paessler M, Bunin N. Donor T-cell-mediated pancytopenia after haploidentical hematopoietic stem cell transplant for severe combined immunodeficiency. J Pediatr Hematol Oncol. 2009 Feb;31(2):148-50. Cited in PubMed: PMID 19194205. Read abstract
Pierson TM, Bonnemann CG, Finkel RS, Bunin N, Tennekoon GI. Umbilical cord blood transplantation for juvenile metachromatic leukodystrophy. Ann Neurol. 2008 Nov;64(5):583-7. Cited in PubMed: PMID 19067349. Read the article
Fish JD, Duerst RE, Gelfand EW, Orange JS, Bunin N. Challenges in the use of allogeneic hematopoietic SCT for ectodermal dysplasia with immune deficiency. Bone Marrow Transplant. 2009 Feb;43(3):217-21. Epub 2008 Sep 15. Cited in PubMed: PMID 18794870. Read the abstract
- Editorial and Academic Positions
Journal Clinical Oncology
Journal Pediatric Hematology/Oncology
Pediatric Blood and Cancer
American Society Bone Marrow Transplant
Medical and Pediatric Oncology
Journal of Pediatrics
Bone Marrow Transplantation
- Editorial and Academic Positions