Antibody Responses to Meningococcal Vaccine in Hematopoietic Cell Transplant Recipients with Veno-Occlusive Disease Treated with Eculizumab

Treatment with eculizumab increases the risk of invasive meningococcal infection (IMI). We evaluated tetravalent meningococcal vaccine responses in pediatric hematopoietic cell transplant (HCT) recipients with eculizumab for veno-occlusive disease (eculizumab group, n=4) and compared to patients with asplenia/polysplenia (asplenia/polysplenia group, n=2). Among the eculizumab group, two patients had a partial and full antibody response, respectively; two had no response. In contrast, the asplenia/polysplenia group showed full responses. These findings suggest poor vaccine response in HCT patients receiving eculizumab during the early post-HCT period, indicating limited meningococcal vaccine response and a need for antibiotic prophylaxis to prevent IMI in this group.