Inclusion Criteria:

1. A diagnosis of MDS, AA, MF or thal based on currently recognized diagnostic criteria.

2. Explored or undergone established therapies eg haemopoietic stem cell transplant,
immunosuppressive therapy, chemotherapy, growth factors, thalidomide, hypomethylating
agent or androgens, and (a) are deemed not suitable, or (b) refuse or (c) have failed
therapy

3. A preceding follow up period (without or with treatment) of 2-4 months as baseline
(depending on the severity of cytopenia) before being enrolled into this study

4. Understand the trial nature of this treatment, agree to be compliant to medication,
do not self medicate and have signed informed consent

5. Agreeable to regular blood tests and follow up marrow study as listed in schedule

Exclusion Criteria:

1. Life expectancy of shorter than one year

2. Significant organ failure including the following

3. Renal impairment with Cr above 200umol/L

4. Liver impairment with serum bilirubin > 2x upper limits or transaminase >3x upper
limits

5. Escalation of treatment of introduction of new agents including growth factors,
thalidomide, hypomethylating agents, immunosuppressive therapy or androgens once
started on treatment with TCM is not allowed. Continuation of current therapy at same
or lower doses is allowed

6. Women during pregnancy or lactation.