No association of malignant B-cell non-Hodgkin lymphomas with ipsilateral SARS-CoV-2 vaccination

Luise Victoria Claaß; Patrick Mayr; Lisa Paschold; Thomas Weber; Denis Terziev; Bertram Jehs; Richard Brill; Johannes Dober; Bruno Märkl; Claudia Wickenhauser; Piotr Czapiewski; Martin Trepel; Rainer Claus; Mascha Binder

doi:10.1002/cam4.5687

No association of malignant B-cell non-Hodgkin lymphomas with ipsilateral SARS-CoV-2 vaccination

Cancer Med. 2023 Apr;12(8):9313-9321. doi: 10.1002/cam4.5687. Epub 2023 Feb 12.

Authors

Affiliations

¹ Department of Internal Medicine IV, Oncology/Hematology, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany.
² Department of Hematology and Oncology, Medical Faculty, University of Augsburg, Augsburg, Germany.
³ Department of Diagnostic and Interventional Radiology, Medical Faculty, University of Augsburg, Augsburg, Germany.
⁴ Clinic and Policlinic of Radiology, Martin-Luther University Halle-Wittenberg, Halle (Saale), Germany.
⁵ General Pathology and Molecular Diagnostics, Medical Faculty, University of Augsburg, Augsburg, Germany.
⁶ Institute of Pathology, University Hospital Halle (Saale), Martin-Luther-University Halle-Wittenberg, Halle, Germany.
⁷ Department of Pathology, Medical Faculty, Otto-Von-Guericke University Magdeburg, Magdeburg, Germany.
⁸ Department of Pathology Dessau Medical Centre, Institute of Pathology, Dessau, Germany.
⁹ Comprehensive Cancer Center Augsburg (CCCA), Medical Faculty, University of Augsburg, Augsburg, Germany.

Abstract

Purpose: SARS-CoV-2 vaccines cause acute ipsilateral lymph node swelling in an important proportion of vaccines. Thus far, no malignant lymphadenopathies have been reported in temporal context to vaccination in the ipsilateral draining lymph node areas.

Experimental design: Prompted by two cases with unilateral axillary lymphomas that occurred ipsilaterally to prior SARS-CoV-2 vaccination, we systematically retrieved all B-cell non-Hodgkin lymphomas at two German University Medical Centers diagnosed before and after introduction of SARS-CoV-2 vaccines in Germany. Available lymphoma tissue (n=19) was subjected to next-generation immunosequencing of the IGH locus. Malignant clonotypes were mined in the CoVabDab database and published data sets from 342 uninfected individuals, 55 individuals 28 days after anti-SARS-CoV-2 vaccination and 139 individuals with acute COVID-19 together encompassing over 1 million CDR3 sequences in total.

Results: Of 313 newly diagnosed cases in the two centers and observation periods, 27 unilateral manifestations in the defined deltoid draining regions were identified. The majority thereof were diffuse large B-cell lymphomas (18 of 27 cases). Eleven unilateral cases were diagnosed in the era of SARS-CoV-2 vaccination and 16 in the control period before introduction of such vaccines. Of the 11 unilateral lymphomas that occurred during the vaccination period, ten had received a SARS-CoV-2 vaccine prior to lymphoma diagnosis. These cases were further evaluated. While left-sided were more frequent than right-sided lymphomas (19 vs 8 cases), no statistically significant association of vaccination site and laterality of the lymphoma manifestation was found. The unilateral lymphomas showed a normal range of B-cell receptors typically found in these lymphoma subtypes with no evidence for anti-SARS-CoV-2 sequences in the malignant clonotype.

Conclusions: Together, we found no evidence that the current SARS-CoV-2 vaccines could serve as a trigger for lymphomagenesis in the draining lymph node areas of the deltoid region used for vaccination.

Keywords: B-cell non-Hodgkin lymphoma; SARS-CoV-2 vaccination; VDJ rearrangement; malignant B-cell receptor; unilateral lymphoma site.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

COVID-19 Vaccines / adverse effects
COVID-19* / prevention & control
Humans
Lymphoma* / pathology
Lymphoma, Non-Hodgkin* / pathology
SARS-CoV-2
Vaccination

Substances

COVID-19 Vaccines