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
Director, Stem Cell Transplant
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
Pulsipher, MA, Carlson C, Langholz B, Wall DA, Schultz KR, Bunin N, Kirsch I , Gastier-Foster JM, Borowitz M, Desmarais C, Williamson D, Kalos M, Grupp SA. IgH-V(D)J NGS-MRD measurement pre- and early post-allotransplant defines very low- and very high-risk ALL patients. Blood, 2015, May 28; 125(22):3501-8. (PMID: 25862561; PMCID: 4447864; doi: 10.1182/blood-2014-12-615757; Epub 2015 Apr 10).
Stieglitz E, ward AF, Gerbing RB, Alonzo TA, Arceci RJ, Liu YL, Emanuel PD, WIdemann BC, Cheng JW, Jayaprakash N, Balis FM, Castleberry RB, Bunin NJ, Loh ML, Cooper TM. Phase II/III trial of a pre-transplant farnesyl transferase inhibitor in juvenile myelomonocytic leukemia: A report from the Children’s Oncology Group. Pediatr Blood Cancer, 2015, Apr; 62(4):629-36. (PMID: 25704135; PMCID: 4339233; NIHMS: 643586; doi: 10.1002/pbc.25342; Epub 214 Dec 8.)
Wagner JE Jr, Eapen M, Carter S, Wang Y, Schultz KR, Wall DA, Bunin N, Delaney C, Haut P, Margolis D, Peres E, Verneris MR, Walters M, Horowitz MM, Kurtzberg J. One-unit versus two-unit cord-blood transplantation for hematologic cancers. Blood and Marrow Transplant Clinical Trials Network. N Engl J Med, 2014, Oct 30; 371(18):1685-94. (PMID: 25354103; PMCID: 4257059; NIHMS: 640296; doi: 10.1056/NEJMoa1405584)
Maude SL, Frey N, Shaw PA, Aplenc R, Barrett DM, Bunin NJ, Chew A, Gonzalez VE, Zheng Z, Lacey SF, Mahnke YD, Melenhorst JJ, Rheingold SR, Shen A, Teachey DT, Levine BL, June CH, Porter DL, Grupp SA. Chimeric antigen receptor T cells for sustained remissions in leukemia. N Engl J Med 2014, Oct. 16; 371(16):1507-17. ()PMID: 25317870; PMCID: 4267531; NIHMS: 640298; doi: 10.1056/NEJMoa1407222)
Oshrine B, Morsheimer M, Heimall J, Bunin N. Reduced-intensity for hematopoietic cell transplantation of chronic granulomatous disease. Pediatr Blood Cancer, 2014 Aug 30; (PMID: 25175046; doi: 10.1002pbc.25225)
Pulsipher MA, Langholz B, Wall DA, Schltz KR, Bunin N, Carroll WL, Raetz E, Gardner S, Gastier-Foster JM, Howrie D, Goyal RK, Douglas JG, Borowitz M, Barnes Y, Teachey DT, Taylor C, Grupp, SA. The addition of sirolimus to tacrolimus/methotrexate GVHD prophylaxis in children with ALL: A phase 3 Children’s Oncology Group/Pediatric Blood and marrow Transplant Consortium trial. Blood 2014 March 27, 123(17):2017-25. (PMID: 24497539; PMCID: 3968388; 10.1182/blood-2013-10-534297)
Aplenc R, Zhang MJ, Sung L, Zhu X, Ho VT, Cooke K, Dvorak C, Hale G, Isola LM, Lazarus HM, McCarthy PL, Olsson R, Pulsipher M, Pasquini C, Bunin N. Effect of body mass in children with hematologic malignancies undergoing altogeneic bone marrow transplantation. Regimen-Related Toxicity Working Committee, Center for International Blood and Marrow, Transplant Research. Blood 2014 May 29,123(22):3504-3511. (PMID: 24711663; PMCID: 4041168; 10.1182/blood-2013-03-490334)
Oshrine BR, Olson TS, Bunin N. Mixed chimerism and graft loss in pediatric recipients of an alemtuzumab-based reduced-intensity conditioning regimen for non-malignant disease. Pediatr Blood Cancer. 2014 June 17. (PMID: 24939325)
Dvorak CC, Hassan A, Slatter MA, Honig M, Lnkester AC, Buckley RH, Pulsipher MA, Davis JH, Gungor T, Gabriel M, Bleesing JH, Bunin N, Sedlacek P, Connelly JA, Crawford DF, Notarangelo LD, Pai SY, Hassid J, Veys P, Gennery AR, Cowan MJ. Comparison of outcomes of hematopoietic stem cell transplantation without chemotherapy conditioning by using matched sibling and unrelated donors for treatment of severe combined immunodeficiency. J Allergy Clin Immunol. 2014 Aug 7. [Epub ahead of print]. (PMID: 25109802; PMCID: 4186906; NIHMS: 620070)
Oshrine BR, Li Y, Teachey DT, Heimall J, Barrett DM, Bunin N. Immunologic recovery in children after alternative donor allogeneic transplantation for hematologic malignancies: comparison of recipients of partially T-cell-depleted peripheral blood stem cells and umbilical cord blood. Biol Blood Marrow Transplant. 2013 Nov 19(11):1581-9. (PMID: 23939199)
Seif AE, Naranjo A, Baker DL, Bunin NJ, Kletzel M, Kretschmar CS, Maris JM, McGrady PW, von Allmen D, Cohn SL, London WB, Park JR, Diller LR, Grupp SA. A Pilot Study of Tandem High-Dose Chemotherapy with Stem Cell Rescue as Consolidation for High Risk Neuroblastoma: Children’s Oncology Group Study ANBL00P1. Bone Marrow Transplant. 2013 Jul 48(7):947-52. (PMID: 23334272; PMCID: 3638062; NIHMS: 426908; 10.1038/bmt.2012.276)
- Awards and Honors
2011, Children’s Hospital of Philadelphia Master Clinician Award
2001, Teaching: The Children's Hospital of Philadelphia Faculty Honor Roll for teaching
1976, Graduated Magna cum laude - University of Nebraska - University of Pennsylvania, Philadelphia, PA
- Editorial and Academic Positions
Journal Clinical Oncology
Journal Pediatric Hematology/Oncology
Pediatric Blood and Cancer
American Society Bone Marrow Transplant
Journal of Pediatrics
Bone Marrow Transplantation
Leukemia & Lymphoma Society: Translational Research Grants 2012
Memberships in Professional Organizations
International Society for Hematotherapy & Graft Engineering
American Society Blood & Marrow Transplant
American Society of Hematology
American Society Pediatric Hematology/Oncology
Children's Oncology Group
Pediatric Blood and Marrow Transplant Consortium
- Awards and Honors