Over her 45-year career in medicine, Naomi Luban, M.D., has contributed much to the fields of hematology and transfusion medicine through her clinical research and leadership for the next generation of physicians and researchers. But her focus on service and research discoveries that lead to better patient outcomes is what is most meaningful to the families she has seen at Children’s National Hospital. For families with inherited conditions, including one mother and her son with the same rare blood disorder, Dr. Luban’s extensive knowledge and her skills as a compassionate clinician have made an impact across multiple generations.
Finding Expertise for Rare Blood Conditions at Children’s National
“Dr. Luban has been a major part of my entire life, treating both me and my son Vincent for hereditary spherocytosis,” Maura Trimble said. When Maura was born in 1978, she said her parents struggled to find someone who could provide answers for her health anomalies. But when they visited Children’s National and began seeing Dr. Luban, they finally received the answers they needed. Dr. Luban was an expert on inherited red blood and platelet disorders. Still, in the years Maura was a child, genetic testing was not widely available, making hereditary spherocytosis especially difficult to diagnose. Dr. Luban’s background in hematology research meant she was equipped to diagnose and treat patients with rare inherited conditions before the advent of genetic diagnostic testing.
“Jaundice and lethargy direct those of us in pediatrics in one direction – the liver,” Dr. Luban said. “But Maura’s liver was ruled out as the cause behind her symptoms, leaving her doctors puzzled. When she came to me, by looking at her red blood cells and hearing her story, I put together that she probably had Hereditary Spherocytosis.” Dr. Luban said a test called a red cell osmotic fragility test, which was and is still uncommon at most institutions, was available at Children’s National. Few other institutions offered this diagnostic testing.
“Children’s National, even then, could perform unusual testing leading to rare diagnoses, so we were able to give her family a definitive cause of her chronic jaundice and periodic anemia,” Dr. Luban said.
“Dr. Luban quickly eased my parents’ fears and provided them with information and comfort,” Maura said. “As I grew up, I have fond memories of going to the ‘Bear Hospital,’ as we called Children’s National, to visit my friend Dr. Luban. Each visit brought more information, and I grew to love spending time with her, so I could learn how best to treat my condition.” When she was 11 years old, Maura’s spleen was removed by the surgical team at Children’s National since it had become dangerously enlarged; once removed, it weighed 20 pounds. Her symptoms and her checkup visits to Dr. Luban gradually decreased over time.
“Maura’s red cells were still affected by her condition, but they were no longer getting trapped in her spleen, eliminating her more serious symptoms,” Dr. Luban said.
20 Years Apart: Treating Hereditary Spherocytosis Across Two Generations
“Little did I know that our paths would cross again,” Maura said. “The next time I would see Dr. Luban, it was 2009 and my son Vincent was the patient.” Because Maura’s condition is caused by hereditary genetic mutations causing red cells to be sphere-shaped and rigid, she knew when Vincent was born with jaundice that he may have inherited hereditary spherocytosis.
“When the genetic tests came back positive, the first thing I did was look to see if Dr. Luban was still practicing at the ‘Bear Hospital.’ Thankfully, she was more than willing to see us,” Maura said. Dr. Luban oversaw Vincent’s care, checking on him regularly. But when he was 5 years old, he experienced a hemolytic crisis where his red blood cells were destroyed faster than his body could produce them.
“He was sicker than I ever got, and he could not fight it. He had an enlarged spleen, was jaundiced and lethargic,” Maura said. An ambulance rushed Vincent from the Trimbles’ local emergency room to Children’s National, where Dr. Luban and the team explained that Vincent needed a red blood cell transfusion. Dr. Luban explained splenectomies like Maura had were no longer the recommended standard procedure for patients with hereditary spherocytosis.
“The transfusion was new to me since I had not needed one of those when I was younger, but I knew Vincent was in the best hands,” Maura said. Dr. Luban’s extensive research background and leadership in pediatric transfusion medicine helped Maura feel even more confident in her recommendation. In addition to conducting research and publishing over 190 articles, Dr. Luban oversaw a multi-institutional analysis of practices and complications of blood transfusions in children funded by the National Institutes of Health (NIH). Dr. Luban’s work has appeared in over 40 textbooks, and she served as editor for texts in pediatric transfusion medicine and serves as an editorial board member for Transfusion and the American Journal of Hematology.
Vincent’s Successful Red Blood Cell Transfusion
“Thanks to her, Vincent made a full recovery,” Maura said. Today, Vincent is active and plays ice hockey. Though Maura said she and Vincent still experience lingering fatigue and take longer to recover from illness or rigorous activity, they can take care of themselves due to Dr. Luban’s clear instructions. Dr. Luban said clear communication directly with her patients has always been an important part of how she practiced patient care.
“I believe in using language the patient can understand as a child so they can build on their understanding as they grow,” Dr. Luban said. “For example, Vincent knows that his red cells looked like beach balls under a microscope, rather than closed-hole doughnuts. I had him repeat these easy-to-visualize images back to me. I learned early in my medical training that it is best to communicate with the patient directly, and the parent will also learn and can further reinforce the message if needed,” she said.
“Over the last few years, I have had the chance to watch Dr. Luban interact with my son the way I remember her interacting with me,” Maura said. “She takes her time to ask him lots of questions. She makes sure he understands everything she is doing, the implications of his condition, and what steps he needs to take to keep himself safe and healthy, like making up rhymes to help him remember to eat the right kind of foods. Over the years, Dr. Luban has provided our family with a wealth of information to support our continued growth and development. She has become like family.”
A Career Built on Service and Discovery at Children’s National
Today, Dr. Luban’s role has transitioned from direct patient care and clinical laboratory oversight to workforce development and programming. She runs junior faculty research programs and oversees pipeline programs, including Mentored Experience to Expand Opportunities in Research for high school students (METEOR v HS) to encourage them to pursue careers in STEM fields and SCIENCE with Dr. Bear which introduces scientific concepts to children in grade school; this program is now being used by Girl Scouts and other out of school time programs to explain STEM and preventative health concepts. She serves as the Vice-Chair of the Institutional Review Board (IRB) for Children’s National, Associate Program Director for the NCATS-funded KL2 program, and Vice-Chair for Faculty Affairs at Children's National. For her research contributions to her field and her work on behalf of families like the Trimbles, she is receiving the 2022 Mount Sinai Jacobi Award – one of Mount Sinai’s most prestigious awards – honoring those who have distinguished themselves in education, clinical and patient care, biomedical science or service. Dr. Luban is one of the only recipients who is not a Mount Sinai faculty member, underscoring her achievements in her field.
“Discovery drives me,” Dr. Luban said of her long career. “Service underlies everything I do. There were very few women in the field when I attended medical school, so I am always trying to pay it forward and serve the next generations. I am always trying to serve patients through the discovery of new therapies and new interventions or excite others to make discoveries.”