Inclusion Criteria:

A patient will be eligible for study participation if all of the following criteria are
met:

1. The patient must sign and date the IRB/IEC approved Informed Consent Form/HIPAA
Authorization prior to study participation.

2. Patient is at least 18 years of age.

3. If female:

1. Patient, either male or female, is either not of childbearing potential, defined
as postmenopausal for at least 1 year or surgically sterile (bilateral tubal
ligation, bilateral oophorectomy or hysterectomy), or if of childbearing
potential, must comply with an effective method of birth control acceptable to
the Investigator during the study (oral contraceptives, Depo-Provera,
intra-uterine device), for at least 1 month prior to enrollment and for 1 month
following the completion of the study.

2. Patient is not breastfeeding.

3. Patient of childbearing potential must have a negative urine or serum pregnancy
test during the screening period.

4. Patient has a diagnosis of low- or intermediate-1 risk MDS, as determined by the
International Prognostic Scoring (IPSS) (score of 0-1).

5. Patient must be transfusion dependent (i.e., received ≥ 2 units over an 8-week period
prior to registration) or have a hemoglobin value ≤ 10 g/dL on the screening
laboratories.

6. Patients must have ≤ 10% blasts in the bone marrow and peripheral blood.

7. Patient must have a platelet counts > 50,000/microliters and absolute neutrophil
counts (ANC) >500/microliters.

8. Patient must have adequate hepatic and renal functions, defined as serum bilirubin,
serum glutamic-oxaloacetic transaminase (SGOT), and serum glutamate pyruvate
transaminase (SGPT) ≤ 2 times the upper limit of normal (ULN), and creatinine ≤ 1.5
times the ULN.

9. Patient must have an ECOG score of ≤ 2.

10. The patient has a negative human immunodeficiency virus antibody (HIV) test result.

Exclusion Criteria:

A patient will be ineligible for study participation if any of the following criteria are
met:

1. The patient has a history of an allergic reaction or significant sensitivity to
Panhematin®.

2. The patient has taken or used any investigational drug or device in the 30 days prior
to screening.

3. The patient has chronic myelomonocytic leukemia (CMML).

4. The patient has a history of deep vein thrombosis or known hypercoagulable state.

5. The patient has a history of a pre-existing medical condition that, in the opinion of
the investigator, will interfere with the participation in the study.

6. The patient has poor peripheral venous access, if central venous access is not
available.

7. The patient has an uncontrolled active infection.

8. The patient has positive test results for hepatitis B surface antigen, and hepatitis
C virus antibody.

9. The patient has any other condition or prior therapy that, in the opinion of the
Investigator, would make the patient unsuitable for the study.