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Paul Allen and Non-Hodgkin's Lymphoma

paul allenPaul Allen was ranked as the 44th-richest person in the world ($20.3 billion), co-founded Microsoft with Bill Gates and then went on to found his own company, Vulcan Inc., that owned research, media, technology and spaceflight companies.  He owned three major sports teams and gave away more than $2 billion for philanthropic projects in science, education, wildlife conservation, the arts and community services.  He suffered from non-Hodgkin's lymphoma and died at age 65 on October 15, 2018, from septic shock brought on by the cancer and its treatment.  
 
Birth of the Personal Computer
Allen was brilliant and hardworking as a student and got a perfect 1600 score on his college boards.  In high school he tutored Bill Gates, who was two years younger, on the use of computers.  Allen went to the University of Washington but dropped out after two years because he thought college was a waste of his time.  He moved to Boston to work as a programmer for Honeywell, where nearby, Bill Gates was wasting his time at Harvard.  Allen convinced Gates to join him and in 1975, when they were 22 and 20, they founded Microsoft to sell a program to manufacturers of small computers.  From there, Microsoft went on to dominate the personal computer industry. 
 
At age 29, Allen was diagnosed with Hodgkin's disease, a cancer of his lymph nodes, and was unable to work at his usual rate of "all the time".  This forced Gates to carry most of the load of running Microsoft, so Gates asked Allen to surrender some of his shares in the company.  Allen agreed, but Gates never took any of the shares back.  In 1983, at age 30, Allen left Microsoft and he refused Gates' offer to buy him out at a price below market value. As a result, Allen became a billionaire when Microsoft went public. 
 
His treatments with radiation and chemotherapy appeared to have cured his Hodgkin's disease.  He went on to manage multiple investments and patented many new discoveries in science and computer fields.  He invested $243 million to buy 80 percent of Ticketmaster and sold it for billions.  He owned the Seattle Seahawks of the National Football League, the Portland Trail Blazers of the National Basketball Association, and the Seattle Sounders FC, of Major League Soccer. He also owned one of the world's largest (414') yachts, The Octopus, that had two helicopters, a submarine, a remotely operated underwater vehicle, a swimming pool, a music studio and a basketball court.  Allen never married and had no children.
 

His Cancer Diagnoses
After facing down Hodgkin's lymphoma at age 29, Allen believed that he had been cured. However, in 2009 at age 56, he was diagnosed with non-Hodgkin's lymphoma.  He appeared to be doing well after being treated with newer cancer drugs, but after nine years, the lymphoma overwhelmed his body and he died from toxic shock, an uncontrollable infection in his bloodstream.
 
Both Hodgkin's and Non-Hodgkin’s lymphoma are cancers of the lymphocyte cells that help to protect you from infections.  The two main types of lymphocytes are B cells and T cells.  B cells produce antibodies that are used to attack and kill invading bacteria, viruses, and toxins. T cells destroy the cells that have invaded by attacking viruses and cancer cells.   Allen had a B cell lymphoma and nobody knows whether his second cancer was caused by the treatment for his first cancer, or by his immune system being weakened by the first cancer or a chronic infection.  We do know that both the Hodgkin’s disease, the non-Hodgkin’s lymphoma and all his treatments suppressed his immunity. 
 
All cells in your body are supposed to live a prescribed length of time and then die.  Cancer means that the cells do not die at their programmed time, so they can overgrow to replace and destroy other cells in your body.  We know that many cases of Hodgkin's lymphoma are associated with infections and a weakened  immunity, but we have not shown that most cases of non-Hodgkin's lymphoma are caused by infections.  Non-Hodgkin's lymphoma is associated with a weakened immunity and autoimmune diseases in which your immune system attacks your own body.
 

The Difference between Hodgkin's and Non-Hodgkin’s Lymphoma
The symptoms for both can be the same.  When a person suffers fatigue, fever, night sweats, itching, weight loss, and non-painful enlarged lymph nodes in the neck, under the arms, or in the groin, the doctors do biopsies of a swollen lymph node or bone marrow and the pathologists look at the tissue under a microscope.  If they see specific multi-nucleated cells called Reed–Sternberg cells, the diagnosis is Hodgkin’s lymphoma. If they do not see these cells, the diagnosis is non-Hodgkin's lymphoma.  This is a very important test because Hodgkin’s disease has a high rate of cure, while non-Hodgkin’s disease is usually not highly curable.   Hodgkin's lymphoma usually occurs in younger people in their 20s or 30s, while non-Hodgkin's lymphoma usually occurs later in life in people 65–75 years old.
 
Risk Factors and Treatments
Risks for both types of lymphomas are increased by chronic infections or anything that damages your own ability to kill germs:  Infectious agents (such as Epstein-Barr virus), any cancer that suppresses a person's immunity, Helicobacter pylori infections, HHV-8 infection, HTLV, hepatitis C virus, HIV, chemicals that suppress immunity (such as polychlorinated biphenyls, diphenylhydantoin, dioxin or phenoxy herbicides), radiation therapy, chemotherapy and autoimmune diseases.
 

About half of the cases of Hodgkin's lymphoma are caused by Epstein–Barr virus, while other cases are associated with serious diseases that suppress a person' s immunity such as AIDS.  It is treated with chemotherapy, radiation therapy and stem cell transplant, depending on how far the disease has spread.  The five-year survival in the United States is 86 percent, and over 97 percent for patients under age 20.  However, radiation and chemotherapy increase risk for other cancers, heart attacks and lung disease in the future, so Allen's  treatment for Hodgkin's lymphoma put him at increased risk for non-Hodgkin's lymphoma and other cancers.
 
Treatments for non-Hodgkin's lymphoma include chemotherapy, radiation, immunotherapy, targeted therapy, stem cell transplantation, surgery, and sometimes just watchful waiting. The five-year survival rate is 71 percent.
 
January 21, 1953 - October 15, 2018
October 28th, 2018
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About the Author: Gabe Mirkin, MD

Sports medicine doctor, fitness guru and long-time radio host Gabe Mirkin, M.D., brings you news and tips for your healthful lifestyle. A practicing physician for more than 50 years and a radio talk show host for 25 years, Dr. Mirkin is a graduate of Harvard University and Baylor University College of Medicine. He is board-certified in four specialties: Sports Medicine, Allergy and Immunology, Pediatrics and Pediatric Immunology. The Dr. Mirkin Show, his call-in show on fitness and health, was syndicated in more than 120 cities. Read More
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