Louis K. Diamond (1902-1999)
Louis K. Diamond was the founding father of pediatric hematology, and inventor of the exchange transfusion for erythroblastosis fetalis.
Diamond was born in the Ukraine on May 11, 1902. At the age of two, his parents immigrated to the United States, and he grew up in Manhattan. He entered Harvard University in 1919 and worked his way through school. He became interested in pediatrics while working as a camp counselor in New England during the summers.
Diamond went to medical school at Harvard, graduating in 1927, then completed a pediatric internship and residency at Children’s Hospital of Boston. In 1932, Diamond and his mentor, Kenneth Blackfan, MD, recognized that fetal hydrops, severe neonatal jaundice, and anemia, were all manifestations of a single syndrome, which they termed erythroblastosis fetalis.(1) Diamond went on to make many contributions in the area of both hematologic testing and therapies. His lab developed techniques for the detection of antibodies and blood typing. He was the first to identify thallasemia, a hereditary anemia affecting children of Italian and Greek ancestry.
The causal relationship between Rh incompatibility(2) and erythroblastosis was not identified until 1941. After the underlying cause of erythroblastosis was determined, Diamond realized that treatment of the condition would require removing the damaged RBC and maternal antibodies and lowering bilirubin levels and replacing the baby’s blood with donor antibody-negative blood, a process now known as “exchange transfusion.” He performed the first exchange transfusion using an umbilical venous catheter in 1946. He also launched the modern field of cancer chemotherapy by reporting the first successful use of aminopterin to treat childhood acute lymphocytic leukemia.
Dr. Blackfan received many honors, including the Mead Johnson Award, the Apgar Award of the AAP, the Howland Award of the American Pediatric Society, the Theodore Roosevelt Medal for for Distinguished Public Service in Science, and the Karl Landsteiner Memorial Award of the AARB. He authored or coauthored over 200 papers and many textbooks. Among the many blood groups and diseases he discovered, three bear his name: Diamond-Blackfan Syndrome, Gardner-Diamond Syndrome, and Schwachman-Diamond Syndrome.
In the course of his career, Dr. Diamond set up the Blood Grouping Laboratory of Boston, served as a Professor of Pediatrics at Harvard and Associate Chief of Staff of Boston Children’s Hospital, and spent two years as the first medical director of the American Red Cross’s National Blood Program. After mandatory retirement from Harvard at the age of 65, he moved to California and worked at UC San Francisco from 1968 to 1987, then at UCLA Medical School until he was in his 90s. He died at home in Los Angeles on June 14, 1999, at the age of 98.
After treatment of mothers potentially sensitized mothers with RhoGAM(TM) became available in 1968, erythroblastosis fetalis and exchange transfusions became rare events, and many young pediatricians have never seen either one. As a resident and fellow in the late 1970s, i probably performed a few of the last exchange transfusions to occur in our hospital. However, Diamond’s discoveries saved the lives of many babies and prevented many cases of kernicterus and mental retardation before RhoGAM became a standard of practice.
- See also: “Historical Perspective on ‘Exchange Transfusion’,” by Louis K. Diamond, Vox Sang 45:333-335, 1983.
(1) Erythroblastosis fetalis and its association with universal edema of the fetus, icterus gravis neonatorum and anemia of the newborn, by Louis K. Diamond, Kenneth D. Blackfan, and James M. Baty. Journal of Pediatrics 1(3), September 1932. DOI:https://doi.org/10.1016/S0022-3476(32)80057-0
(2) The Rh antibody was named after the Rhesus monkeys where it was first identified.