Department of Internal Medicine IV, Oncology/Hematology, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany.
Department of Hematology and Oncology, Medical Faculty, University of Augsburg, Augsburg, Germany.
Cancer Med. 2023 Apr;12(8):9313-9321. doi: 10.1002/cam4.5687. Epub 2023 Feb 12.
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.
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.
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.
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.
SARS-CoV-2 疫苗会导致相当比例的疫苗接种者出现急性同侧淋巴结肿大。迄今为止，在同侧引流淋巴结区域接种疫苗的同时，尚未有恶性淋巴结病的报告。
由于两例同侧发生的腋窝淋巴瘤病例的提示，我们系统性地检索了两家德国大学医学中心在德国引入 SARS-CoV-2 疫苗前后诊断的所有 B 细胞非霍奇金淋巴瘤。可获得的淋巴瘤组织（n=19）进行了 IGH 基因座的下一代免疫测序。从 CoVabDab 数据库和来自 342 名未感染个体、55 名接种抗 SARS-CoV-2 疫苗后 28 天的个体和 139 名急性 COVID-19 个体的已发表数据集中挖掘恶性克隆型，总共涵盖了超过 100 万条 CDR3 序列。
在这两个中心和观察期间的 313 例新诊断病例中，确定了 27 例在定义的三角肌引流区域的单侧表现。其中大多数为弥漫性大 B 细胞淋巴瘤（27 例中的 18 例）。11 例单侧病例发生在 SARS-CoV-2 疫苗接种时代，16 例发生在引入此类疫苗之前的对照期。在接种疫苗期间发生的 11 例单侧淋巴瘤中，有 10 例在淋巴瘤诊断前接种了 SARS-CoV-2 疫苗。对这些病例进行了进一步评估。虽然左侧比右侧淋巴瘤更为常见（19 例 vs 8 例），但未发现疫苗接种部位与淋巴瘤表现的侧别之间存在统计学显著关联。这些单侧淋巴瘤表现出通常在这些淋巴瘤亚型中发现的正常 B 细胞受体范围，恶性克隆型中没有抗 SARS-CoV-2 序列的证据。
总的来说，我们没有发现当前的 SARS-CoV-2 疫苗会成为三角肌区域引流淋巴结中发生淋巴瘤的触发因素的证据。
