ORIGINAL ARTICLES: Clinical researchRisk of intracranial hemorrhage with anticoagulation therapy in melanoma patients with brain metastasesAlvarado, Gladysa; Noor, Rahata; Bassett, Rolandb; Papadopoulos, Nicholas E.a; Kim, Kevin B.a; Hwu, Wen-Jena; Bedikian, Agopa; Patel, Sapnaa; Hwu, Patricka; Davies, Michael A.a,cAuthor Information Departments of aMelanoma Medical Oncology bBiostatistics and Applied Mathematics cSystems Biology, University of Texas, MD Anderson Cancer Center, Houston, Texas, USA Gladys Alvarado and Rahat Noor contributed equally to the writing of this article. Correspondence to Michael A. Davies, MD, PhD, University of Texas, MD Anderson Cancer Center, 7455 Fannin, Unit 0904, Houston, TX 77054, USA Tel: +1 713 792 3454; fax: +1 713 563 3424 e-mail: [email protected] Received December 16, 2011 Accepted March 20, 2012 Melanoma Research: August 2012 - Volume 22 - Issue 4 - p 310-315 doi: 10.1097/CMR.0b013e328353efd8 Buy Metrics Abstract Venous thromboembolism (VTE) is a frequent complication in melanoma patients with brain metastases (BM). The management of these patients is challenging because of the high risk of intracranial hemorrhage (ICH) and the limited data available on the safety of anticoagulation in this scenario. We reviewed the treatments and outcomes among melanoma patients with BM and VTE at our institution to determine the safety of anticoagulation in these patients. A retrospective chart review was performed to identify melanoma patients with BM who were diagnosed with VTE. The clinical characteristics of the BM and the VTE, the treatments given for VTE, subsequent ICH, and overall survival (OS) were determined. The characteristics and outcomes were compared between patients who received systemic anticoagulation and those who did not. A total of 74 evaluable melanoma patients with BM and VTE were identified. Fifty-seven (77%) patients received systemic anticoagulation. There was no significant difference in the number (P=0.40) or the maximum diameter (P=0.55) of brain metastasis between the patients who received anticoagulation and those who did not. Two (4%) patients who received anticoagulation developed ICH, which was not statistically different from the patients who did not receive anticoagulation (0%, P=1.00). There was a trend toward longer OS from VTE among patients who received systemic anticoagulation (median OS: 4.2 vs. 1.2 months, P=0.06). Anticoagulation for VTE did not significantly increase the risk of ICH or decrease OS in patients with melanoma BM. These data support the safety of systemic anticoagulation for VTE in these patients. © 2012 Lippincott Williams & Wilkins, Inc.