International normalized ratio (INR) and activated partial thromboplastin time (aPTT) =< . x ULN (this applies only to patients who do not receive therapeutic anticoagulation; patients receiving therapeutic anticoagulation, such as low-molecular-weight heparin or warfarin, should be on a stable dose), within weeks of randomization Coagulation parameters\t(international normalized ratio [INR], activated partial thromboplastin time [aPTT]) =< . x institutional limits, except where a lupus anti-coagulant has been confirmed or the patient is on warfarin; patients on full dose anticoagulation must be on a stable dose for at least days. If receiving warfarin, the patient must have an INR =< . without any evidence of active bleeding within days prior to first dose of study treatment or a pathologic condition that carries a high risk of bleeding (tumor involvement with major blood vessels or varicies), within days prior to administration of study treatment International normalized ratio (INR) and activated partial thromboplastin time (aPTT) =< . x ULN (or on stable dose of therapeutic anticoagulation, such as low-molecular-weight heparin, warfarin or rivaroxaban) Patients on low molecular weight heparin or Coumadin (with a stable international normalized ratio [INR]) are eligible International normalized ratio (INR) and activated partial thromboplastin time (aPTT) =< . x ULN (this applies only to patients who do not receive therapeutic anticoagulation; patients receiving therapeutic anticoagulation, such as low-molecular-weight heparin or warfarin, should be on a stable dose) Patients receiving full dose anticoagulation therapy (e.g., warfarin or low molecular weight [LMW] heparin) and does not meet both of the following criteria: \r\n* No active bleeding or pathological condition that carries a high risk of bleeding (e.g., tumor involving major vessels or known varices)\r\n* In-range international normalized ratio (INR) (usually between and ) on a stable dose of oral anticoagulant or on a stable dose of low molecular weight heparin Obtained =< days prior to registration: International normalized ratio (INR) and activated partial thromboplastin time (aPTT) =< . x ULN; NOTE: This applies only to patients who are not receiving therapeutic anticoagulation; patients receiving therapeutic anticoagulation should be on a stable dose International normalized ratio (INR) and activated partial thromboplastin time (aPTT) =< . x ULN (this applies only to patients who do not receive therapeutic anticoagulation; patients receiving therapeutic anticoagulation, such as low-molecular-weight heparin or warfarin, should be on a stable dose) Adequate coagulation function as defined by international normalized ratio (INR) =< . and a partial thromboplastin time (PTT) < . x institutional upper limit of normal; patients on full-dose anticoagulation must be on a stable dose (minimum duration days) of oral anticoagulant or low molecular weight heparin Prothrombin time (PT) such that international normalized ratio (INR) is < . (or an in-range INR, usually between and , if a patient is on a stable dose of therapeutic warfarin or low molecular weight heparin) and a partial thromboplastin time (PTT) < . times control International normalized ratio (INR) and partial thromboplastin time (aPTT) =< . x ULN (this applies only to patients who do not receive therapeutic anticoagulation; patients receiving therapeutic anticoagulation, such as low-molecular-weight heparin or warfarin, should be on a stable dose) Adequate coagulation function as defined by International Normalized Ratio (INR) =< . and partial thromboplastin time (PTT) =< seconds above the ULN (unless receiving anticoagulation therapy); patients receiving warfarin must be switched to low molecular weight heparin and have achieved stable coagulation profile prior to first dose of protocol therapy International normalized ratio (INR) =< .; (anticoagulation with low molecular weight heparin is allowed if on a stable dose for > weeks at time of enrollment) International normalized ratio (INR) and activated partial thromboplastin time (aPTT) =< . x ULN. This applies only to patients who do not receive therapeutic anticoagulation; patients receiving therapeutic anticoagulation (such as low-molecular-weight heparin or warfarin) should be on a stable dose. STUDY TREATMENT: International normalized ratio (INR) and activated partial thromboplastin time (aPTT) =< . ULN within days prior to the first study treatment.\r\n* This applies only to patients who do not receive therapeutic anticoagulation; patients receiving therapeutic anticoagulation (such as low-molecular-weight heparin or warfarin) should be on a stable dose. International normalized ratio (INR) =< . x ULN (this applies only to patients who do not receive therapeutic anticoagulation; patients receiving therapeutic anticoagulation, such as low-molecular-weight heparin or warfarin, should be on a stable dose) Activated partial thromboplastin time (aPPT) =< . x ULN (this applies only to patients who do not receive therapeutic anticoagulation; patients receiving therapeutic anticoagulation, such as low-molecular-weight heparin or warfarin, should be on a stable dose) International normalized ratio (INR) =< .; anticoagulation is allowed only with low molecular weight heparin (LMWH); patient receiving LMW heparin on stable therapeutic dose for more than weeks or with factor Xa level < . U/mL are allowed on the trial International normalized ratio (INR) and activated partial thromboplastin time (aPTT) =< . x ULN.\r\n* This applies only to patients who do not receive therapeutic anticoagulation; patients receiving therapeutic anticoagulation (such as low-molecular-weight heparin or warfarin) should be on a stable dose. International normalized ratio (INR) and activated partial thromboplastin time (aPTT) =< . x ULN if not on therapeutic anticoagulation; patients receiving therapeutic anticoagulation will be allowed if maintained on a stable dose within days of study registration International normalized ratio (INR) and partial thromboplastin time (PTT) =< . x ULN prior to study entry. Therapeutic anticoagulation with warfarin is allowed if target INR =< on a stable dose of warfarin or on a stable dose of low molecular weight (LMW) heparin for > weeks ( days) at the time of enrollment. International normalized ratio (INR) and activated partial thromboplastin time (aPTT) =< . x ULN; this applies only to patients who are not receiving therapeutic anticoagulation; patients receiving therapeutic anticoagulation should be on a stable dose International normalized ratio (INR) and activated partial thromboplastin time (aPTT) > . x upper limit of normal (ULN) \r\n* This applies only to patients who are not receiving therapeutic anticoagulation; patients receiving therapeutic anticoagulation should be on a stable dose Within days prior to cycle day of treatment: International normalized ratio (INR) or prothrombin time (PT) activated partial thromboplastin Time (aPTT) =< . x ULN (Note: This applies only to subjects who are not receiving therapeutic anticoagulation; subjects receiving therapeutic anticoagulation should be on a stable dose) Anticoagulation is allowed if target INR =< . on a stable dose of warfarin or on a stable dose of anticoagulant for > weeks at time of randomization; for patients on therapeutic anti-coagulants, medication must be clinically held peri-procedure (bone marrow aspirate) per standard clinical management Within days prior to the first study treatment (cycle , day ): International normalized ratio (INR) and activated partial thromboplastin time (aPTT) =< . x ULN\r\n* This applies only to patients who do not receive therapeutic anticoagulation; patients receiving therapeutic anticoagulation (such as low-molecular-weight heparin or warfarin) should be on a stable dose International normalized ratio (INR) and activated partial thromboplastin time (aPTT) =< . x ULN\r\n* This applies only to patients who do not receive therapeutic anticoagulation; patients receiving therapeutic anticoagulation (such as low-molecular-weight heparin or warfarin) should be on a stable dose International normalized ratio (INR) and partial thromboplastin time (PTT) =< . x ULN within days prior to study entry; therapeutic anticoagulation with warfarin is allowed if target INR =< on a stable dose of warfarin or on a stable dose of low molecular weight (LMW) heparin for > weeks ( days) at the time of enrollment International normalized ratio (INR) and activated partial thromboplastin time (aPTT) ? . X ULN; this applies only to patients who do not receive therapeutic anticoagulation; patients receiving therapeutic anticoagulation (such as low-molecular-weight heparin or warfarin) should be on a stable dose International normalized ratio (INR) > and/or partial thromboplastin time (PTT) > \r\n* Patients who are on anticoagulation medication that may not be safely held for the procedure (>= days for antiplatelet agents and warfarin; >= hours for low-molecular weight heparin formulations) will be excluded International normalized ratio (INR) and activated partial thromboplastin time (aPTT) =< . x ULN; this applies only to patients who do not receive therapeutic anticoagulation; patients receiving therapeutic anticoagulation (such as low-molecular-weight heparin or warfarin) should be on a stable dose Prothrombin (PT) and activated partial thromboplastin time (aPTT) =< . x upper limit of normal (ULN) prior to biopsy; patients with prior history of thrombosis/embolism are allowed to be on anticoagulation, understanding that anticoagulation will be held in the perioperative period per the neurosurgical teams recommendations; low molecular weight heparin (LMWH) is preferred; if a patient is on warfarin, the international normalized ratio (INR) is to be obtained and value should be below . prior to biopsy International normalized ratio (INR) > . and/or partial thromboplastin time (PTT) > \r\n* Patients who are on anticoagulation medication that may not be safely held for the procedure (>= days for antiplatelet agents and warfarin; >= hours for low-molecular weight heparin formulations) will be excluded International normalized ratio (INR) =< .; (anticoagulation is allowed if target INR =< . on a stable dose of warfarin or on a stable dose of low molecular weight [LMW] heparin for > weeks at the first dose of study agent) Prothrombin time/international normalized ratio (PT/INR) < . for patients not on warfarin confirmed by testing within days prior to registration; patients on full-dose anticoagulants (e.g., warfarin or low molecular weight [LMW] heparin) must meet both of the following criteria:\r\n* No active bleeding or pathological condition that carries a high risk of bleeding (e.g., tumor involving major vessels or known varices)\r\n* In-range INR (between . and .) on a stable dose of warfarin-based oral anticoagulant; or on a stable dose of low molecular weight heparin; or INR between . and if a Greenfield filter is in place Prothrombin time (PT) such that international normalized ratio (INR) is < . (or an in-range INR, usually between and , if a patient is on a stable dose of therapeutic warfarin or low molecular weight heparin) and a partial thromboplastin time (PTT) < . times control The subject has adequate coagulation function as defined by international normalized ratio (INR) =< . and a partial thromboplastin time (PTT) (PTT/aPTT) < . x ULN\r\n* Patients receiving warfarin must be switched to low molecular weight heparin and have achieved stable coagulation profile prior to first dose of protocol therapy International normalized ratio (INR) =< .; (anticoagulation is allowed if target INR =< . on a stable dose of warfarin or on a stable dose of low molecular weight [LMW] heparin for > weeks at time of randomization) International normalized ratio (INR) =< . and partial thromboplastin time (PTT) =< . x ULN for patients who are not being treated with therapeutic anticoagulation; therapeutic or prophylactic anticoagulation is allowed if a patient has been on a stable dose of low molecular weight (LMW) heparin for > weeks at the time of randomization; subjects on therapeutic or prophylactic anticoagulation including warfarin will have PTT and INR as determined by the Investigator; prophylactic use of an anticoagulant to maintain patency of a vascular access device is also allowed) International normalized ratio (INR) and activated partial thromboplastin time (aPTT) ? . ULN (this applies only to patients who do not receive therapeutic anticoagulation; patients receiving therapeutic anticoagulation, such as low-molecular-weight heparin or warfarin, should be on a stable dose) International normalized ratio (INR) and activated partial thromboplastin time (aPTT) =< . x ULN (This applies only to patients who do not receive therapeutic anticoagulation; patients receiving therapeutic anticoagulation [such as low-molecular-weight heparin or warfarin] should be on a stable dose.) International normalized ratio (INR) and activated partial thromboplastin time (aPTT) =< . x ULN\r\n* This applies only to patients who do not receive therapeutic anticoagulation; patients receiving therapeutic anticoagulation (such as low-molecular-weight heparin or warfarin) should be on a stable dose International normalized ratio (INR) and activated partial thromboplastin time (aPTT) =< . x ULN\r\n* This applies only to patients who do not receive therapeutic anticoagulation; patients receiving therapeutic anticoagulation (such as low?molecular weight heparin or warfarin) should be on a stable dose International normalized ratio (INR) =< . (unless receiving anticoagulation therapy); patients on full-dose anticoagulation must be on a stable dose (minimum duration days) of oral anticoagulant or low molecular weight heparin; if receiving warfarin, the patient must have an INR =< . and no active bleeding (i.e., no bleeding within days prior to first dose of study therapy) International normalized ratio (INR) =< ., and a partial thromboplastin time (PTT) =< seconds above the ULN (unless receiving anticoagulation therapy); patients receiving warfarin must be switched to low molecular weight heparin and have achieved stable coagulation profile prior to first dose of protocol therapy SUB-PROTOCOL AIM A: Adequate coagulation function as defined by either of the following criteria:\r\n* International normalized ratio (INR) =< . x ULN\r\n* For subjects receiving warfarin or low molecular weight heparin (LMWH), the subjects must, in the investigators opinion, be clinically stable with no evidence of active bleeding while receiving anticoagulant therapy; the INR for these patients may exceed . x ULN if that is the goal of the anticoagulant therapy International normalized ratio (INR) weeks at time of randomization Patients on full-dose anticoagulation are eligible if the following criteria are met:\r\n* Patient has an in-range international normalized ratio (INR) (usually -) on a stable dose of warfarin or is on a stable dose of low molecular weight heparin\r\n* Patient has no active bleeding or pathological condition that carries a high risk of bleeding (i.e., tumor involving major vessels or known varices) \r\n* Patients receiving anti-platelet agents are eligible; in addition, patients who are on daily prophylactic aspirin or anticoagulation for atrial fibrillation are eligible International normalized ratio (INR) =< . x ULN; partial thromboplastin time (PTT) =< . x ULN, within days of registration; therapeutic anticoagulation with warfarin is allowed if target INR =< on a stable dose of warfarin or on a stable dose of low molecular weight (LMW) heparin for > weeks ( days) at time of randomization International normalized ratio (INR) =< .; anticoagulation is allowed if target INR =<, . on a stable dose of warfarin or if patient on a stable dose of low molecular weight (LMW) heparin for > weeks at time of enrollment International normalized ratio (INR) and partial thromboplastin time (PTT) =< . x ULN; (anticoagulation is allowed if target INR =< . on a stable dose of warfarin or on a stable dose of low molecular weight [LMW] heparin for > weeks at time of randomization) International normalized ratio (INR) and activated partial thromboplastin time (aPTT) =< . x ULN (this applies only to patients who do not receive therapeutic anticoagulation; patients receiving therapeutic anticoagulation, such as low-molecular-weight heparin or warfarin, should be on a stable dose) The patient has a prothrombin time (PT) (international normalized ratio [INR]) =< . and a partial thromboplastin time (PTT) =< seconds above the upper limits of normal if the patient is not on anticoagulation; if a patient is on full-dose anticoagulants, the following criteria should be met for enrollment: \r\n* The patient must have an in-range INR (usually between and ) on a stable dose of warfarin or on stable dose of low molecular weight (LMW) heparin\r\n* The patient must not have active bleeding or pathological conditions that carry high risk of bleeding (e.g. tumor involving major vessels, known varices) Prothrombin time (PT) such that international normalized ratio (INR) is =< . (or an in-range INR, usually between and , if a patient is on a stable dose of therapeutic warfarin) and a partial thromboplastin time (PTT) =< . times the institutional upper limit of normal; patients receiving low molecular weight heparin for the prevention or treatment of venous thromboembolic disease are eligible if considered clinically stable on their regimen International normalized ratio (INR) and partial thromboplastin time (PTT) =< . x UNL; NOTE: anticoagulation is allowed if target INR =< . x UNL on a stable dose of warfarin or on a stable dose of low molecular weight heparin for > weeks at time of registration Patients on full-dose anticoagulants (e.g., warfarin) with prothrombin time (PT) international normalized ratio (INR) > . are eligible provided that both of the following criteria are met:\r\n* The patient has an in-range INR (usually between and ) on a stable dose of oral anticoagulant or on a stable dose of low molecular weight heparin\r\n* The patient has no active bleeding or pathological condition that carries a high risk of bleeding (e.g., tumor involving major vessels or known varices) International normalized ratio (INR) and partial thromboplastin (PTT) =< . x ULN (anticoagulation is allowed if target INR =< . x ULN on a stable dose of warfarin or on a stable dose of low molecular weight [LMW] heparin for > weeks at time of registration) Patients on full-dose anticoagulants (e.g., warfarin) with prothrombin time (PT) international normalized ratio (INR) > . are eligible provided that both of the following criteria are met:\r\n* The patient has an in-range INR (usually between and ) on a stable dose of oral anticoagulant or on a stable dose of low molecular weight heparin\r\n* The patient has no active bleeding or pathological condition that carries a high risk of bleeding (e.g., tumor involving major vessels or known varices) International normalized ratio (INR) =< .; (anticoagulation is allowed if target INR =< . on a stable dose of warfarin or on a stable dose of low molecular weight [LMW] heparin for > weeks at time of study initiation) Prothrombin time (PT) (international normalized ratio [INR]) > ., unless the patient is on full dose anticoagulants; if so, the following criteria must be met for enrollment:\r\n* The subject must have an in-range INR (usually between -) on a stable of low molecular weight heparin; anticoagulation with warfarin is not allowed International normalized ratio (INR) < . (anticoagulation is allowed if target INR =< . on a stable dose of warfarin or on a stable dose of low molecular weight [LMW] heparin for > weeks at the time of registration) Prothrombin time/international normalized ratio (PT INR) < . for patients not on warfarin confirmed by testing within days prior to registration; patients on full-dose anticoagulants (e.g., warfarin or low molecular weight [LMW] heparin) must meet both of the following criteria:\r\n* No active bleeding or pathological condition that carries a high risk of bleeding (e.g., tumor involving major vessels or known varices)\r\n* In-range international normalized ratio (INR) (between . and .) on a stable dose of warfarin-based oral anticoagulant; or on a stable dose of low molecular weight heparin; or INR between . and if a Greenfield filter is in place International normalized ratio (INR) < ., unless patient is on therapeutic anticoagulation where a therapeutic INR is acceptable; anticoagulation with low molecular weight heparin or warfarin, where medically indicated, is permitted*