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Copyright: © 2026 Gentilini et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. This article investigates the potential association between modified mRNA (modRNA) COVID-19 vaccinations and the development of haematopoietic cancers. We present a case involving a healthy, young, athletic woman who developed acute lymphoblastic leukaemia (ALL) and lymphoblastic lymphoma (LBL) following her second dose of the Pfizer/BioNTech COVID-19 vaccine (Comirnaty®). This case is part of an expanding body of literature documenting similar occurrences after modRNA vaccinations, which we critically examine. Emerging evidence suggests that the biodistribution and persistence of modRNA, facilitated by lipid nanoparticles, can affect various tissues and organs, including the bone marrow and other blood-forming organs. Notably, modRNA vaccines exhibit a particular affinity for the bone marrow, potentially influencing the immune system at multiple levels and triggering both autoimmune disorders and neoplastic processes. In this article, we assess the risk of developing haematopoietic cancers post-modRNA vaccination based on current scientific literature and explore the reported potential genetic and molecular mechanisms involved in disease pathogenesis. By integrating clinical observations and current research, we aim to provide valuable insights into the potential carcinogenic outcomes associated with modRNA vaccination.