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Serologic response to meningococcal vaccination in patients with cold agglutinin disease (CAD) in the novel era of complement inhibition.

Abstract
Cold agglutinin disease (CAD) is a rare, potentially life-threatening acquired autoimmune hemolytic anemia characterized by hemagglutination and hemolysis due to immunoglobulin-mediated (usually IgMκ) classic complement pathway activation. Complement inhibition (CI) represents a novel treatment option to control hemolysis. Due to CI patients (pts) are susceptible to encapsulated bacteria e.g. N. meningitidis. Therefore, meningococcal vaccination on CI is mandatory. In this study serologic response to the tetravalent conjugate vaccine Menveo® was analyzed in CAD pts on eculizumab treatment (DECADE trial) using rabbit serum as complement source (rSBA). Protective rSBA titers varied for meningococcal serogroups and over time reflecting an early decline to even non-protective rSBA titers. These data highlight the importance of serologic analyses under chronic CI. Currently, re-vaccination with a tetravalent meningococcal conjugate vaccine every 3 years is recommended on chronic CI. However, re-vaccination on CI might further rely on serologic analyses, implying even early booster vaccinations similar to adults with (functional) asplenia.
AuthorsFerras Alashkar, Colin Vance, Dörte Herich-Terhürne, Amin T Turki, Christine Schmitz, Martin Bommer, Andreas Hüttmann, Ulrich Dührsen, Ulrich Vogel, Alexander Röth
JournalVaccine (Vaccine) Vol. 37 Issue 44 Pg. 6682-6687 (10 16 2019) ISSN: 1873-2518 [Electronic] Netherlands
PMID31562002 (Publication Type: Clinical Trial, Phase II, Journal Article, Research Support, Non-U.S. Gov't)
CopyrightCopyright © 2019 Elsevier Ltd. All rights reserved.
Chemical References
  • Antibodies, Bacterial
  • Meningococcal Vaccines
  • Complement System Proteins
Topics
  • Aged
  • Aged, 80 and over
  • Anemia, Hemolytic, Autoimmune (blood, immunology)
  • Animals
  • Antibodies, Bacterial (blood, immunology)
  • Complement System Proteins (immunology)
  • Female
  • Humans
  • Male
  • Meningococcal Infections (prevention & control)
  • Meningococcal Vaccines (immunology)
  • Middle Aged
  • Neisseria meningitidis (immunology)
  • Rabbits
  • Serologic Tests

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