Update Technology in Haematology Analyser

Past, Present and Future

Agnes Octavia Lizandi

Apr 23th, 2018

Denpasar, Bali

PT Sysmex Indonesia
Haematology laboratories care about the
systems they use because what they do is
important

A people(s) is (are) behind the numbers

And the world does not stand still, neither does

us.

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Haematology Analysis Milestone

NRBC IG

RET IPF

5-part DIFF 6-part DIFF 2016 2017

Automated Automated
Advanced
Manual Automated Digital
Parameter Slide Maker Morphology

3-part DIFF
WPC BF

LWBC

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Sysmex Haematology Milestone

Sysmex 1st Analyzer XN-L Series

2016
(1964) (2015)
Fully Automated Analyzer

Fluorescence Flowcytometry

Clinical Value Enhancement

Special Parameter:
 RET, RET-He
 PLT-F, IPF
 WPC, HPC 2017
 Body Fluid mode

Operational Simplicity:
 Barcoded / RFID reagent XP-Series
 Full colour and touch screen monitor (2013)
 Reagent Monitoring System XN-Series
 Bahasa Indonesia available on selected type (2012)

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Automated Haematology Analyser
 3-part DIFF
 Classified WBC cells into 3 groups.
 Using impedance technology

 5-part DIFF
 Able to differentiate 5 types of WBC cells and detect cell abnormality (Blast, Immature
Granulocytes, NRBC, etc)
 Using fluorescence flowcytometry (more sophisticated technology)

 6-part DIFF
 Able to differentiate 5 types of WBC cells, count Immature Granulocytes and detect
cell abnormality (Eg. Blast)
 Using fluorescence flowcytometry (more sophisticated technology)

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Automated Haematology Analyser with
Advanced Parameter

Amount of RNA/DNA

Intracellular structure

Cell size

NRBC IG RET IPF WPC BF

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 NRBC (Nucleated Red Blood Cells)
• WBC count have to be corrected if NRBC more than 10 cells / 100 WBC
• Usually found in thalassemia patients
• Clinical significances:

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 IG (Immature Granulocytes)
• Early indicator of inflammations and sepsis
• Better predictor of infection than WBC count

Low WBC Mode is available in Sysmex 6-part DIFF

analyser
• Count WBC 3x normal WB Mode
IG
• Provide differential count for WBC < 1,000/uL

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 RET (Reticulocyte)
• Evaluate bone marrow ability to produce RBCs
• Assist in anemia differential diagnosis (FID vs
IDA)
• Help in iron therapy monitoring in IDA patient

Reticulocytes and Ret-He

a valuable contribution to anemia management

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 IPF (Immature Platelet Fraction)
• Enumerates on PLT-F Channel – using oxazine
staining which specific to PLT (better separation from
RBC fragment)
• PLT-F has strong correlation to CD41/CD61 analysis
• Early indicator for thrombopoietic recovery after
treatment
• Support the differential diagnosis of thrombocytopenia
and therapy monitoring:
o PLT < 150,000/uL and IPF > 7.65%  increased
destruction / consumption in circulation (peripheral)
o PLT < 150,000/uL and IPF < 7.65%  bone marrow is
not responding to thrombocytopenia

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 WPC (White Precursor Cells)
• More specific detection for WBC abnormalities: Blast, Abnormal Lymphocyte, Atypical
Lymphocyte.

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 BF (Body Fluid)
• Standardized, fast, easy and accurate enumeration of blood cells in body fluid samples
• Very useful in emergency medicine

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Sysmex Haematology Portfolio
20 parameter Up to 49 parameter
With advanced parameter and BF analysis

3 part 6 part
DIFF DIFF

• IG is included
• Special parameter are
available

XP-Series XN-L Series

Up to 45 parameter
With advanced parameter,
specific WBC abnormality
detection and BF analysis

XN-Series 6 part
DIFF +
NRBC
• NRBC is included in CBC analysis, IG is included in DIFF analysis
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• Complete secial parameter are available 13
Automated Slide Maker

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Automated Digital Morphology

Sysmex XN-3000 with DI-60 Sysmex XN-9000 with DI-60

Review and Edit Archive Consult

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Sysmex Haematology Systematization

with slide maker and digital morphology

Hematology analyzer with extra benefits:

 XN-Series to help in hematology screening with standard and special parameter
 SP-10 (automated slide preparation) to provide automatic blood smear preparation if necessary
 DI-60 (automated digital morphology) to allow digital morphology analysis

Let the instrument do the groundwork and focus on interpreting the result to reveal the disease and
expand your skills in order to provide better patient care.

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Future Haematology Configuration

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Summary

The world does not stand still, we need to evolve

and embrace new technology to give better
patient care.

There’s no such a perfect test, every test

should be interpreted properly and validated
by the healthcare practitioner.

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Copyright © 2018 PT Sysmex Indonesia
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