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Sysmex Haematology

Tailoring to your laboratory needs

Haematology Workshop
8th Sysmex Scientific Seminar

Agnes Octavia Lizandi


PT Sysmex Indonesia
Sysmex XN-Series Family
Smear and Stain +
Digital Morphology
Cell Counting +

2017
XN-1500 + DI-60
Smear and Stain
Cell Counting +

2016
New in 2018!
Cell Counting

100 CBC tests 100 tests 200 CBC tests 200 CBC tests
30 – 75 slides 120 slides

Throughput per hour


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Sysmex XN-Series

Modular concept and flexible configuration:


Type (parameter) and number of XN unit at your choice!

XN-10 XN-20

OR

Standard

Optional

BF analysis is available on both XN types


Activation
Can be connected up to 9 units by license
only

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Fluoroscence Flowcytometry

Amount of RNA/DNA

Intracellular structure

88 uL
Cell size

XN- XN-
RET PLT-F WPC BF
CBC DIFF

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Flexible Configuration

or

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XN-Series: adding values to standard parameter

NRBCs are directly measured with every CBC


CBC analysis with a linearity up to 600 NRBCs/100
WBCs

➢ Corrected WBCs are reported with high sensitivity and


specificity

➢ Elevated NRBC indicate an ineffective erythropoiesis

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XN-Series: adding values to standard parameter

Immature granulocytes (IG), the 6th differential


population is a standard with every differential
DIFF analysis
Low WBC Mode is avaliablenew!

> IG as early indicators of inflammations and sepsis


> Low WBC mode is a dedicated mode for leucopenia samples (< 1,000/uL)

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XN-Series: providing more clinical values

Providing Reticulocyte count together with


measurement of Reticulocytes Hemoglobin
equivalent (Ret-He)

➢ Differentiation of FID and IDA


➢ Monitoring iron therapy response in CKD (KDOQI 2006, NICE 2015)

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XN-Series: providing more clinical values

Improved performance of PLT quantification in


critical thrombocytopenic range including the
enumeration of immature platelet fraction (IPF).

➢ CV below 5% for PLT < 20.000/uL Strong, Weak, only


especially cell
➢ Good correlation with CD41/61 within the
cell
membrane
Platelet RBC
fragment
➢ Support the differential diagnosis of thrombocytopenia and therapy
monitoring

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XN-Series: providing more clinical values

Specific flagging information for abnormal or


immature white cells (Blasts, Abn. Lymphocyte,
Atypical Lymphocyte)

➢ Giving more specific guidance to for clinical pathologist

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XN-Series: not only blood samples

Available for 5 types of Body fluids with no


additional reagents (FDA Approved)

➢ No special treatment, fast and reliable


➢ Very useful in emergency medicine

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Do we still need manual morphology analysis?

Yes, when there are 1 or more flagging message, manual analysis


is required for confirmation.

What are the challenges in manual morphology


analysis?

• Standardized good quality of smear


• Turn-around-time
• Morphology skills

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A Good Quality Blood Smear

https://quizlet.com/86617934/lo4-quality-stain-of-a-blood-smear-flash-cards/
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But What Actually Happens….

Consequences of Poorly Made Blood Smear

1. Incorrect distribution of leukocytes


2. Thick smears prevent identification
3. Thin smears contain broken cells

Not a true representative of patient which will lead to


poor patient outcome

XN-1500 helps to standardize the


blood smear while maintaining the
good quality of slides

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Sysmex Sytematization

XN-3000

All-in-one Hematology

Count Smear Stain


XN-10 / XN-20 SP-10 / SP-50
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SP-10 / SP-50 Technology

• Smear technology: wedge with adjusted angle based on HCT value from XN

• Staining technology: single / double staining which are compatible with common
staining agent

• New manual preparation function: prepare the smear manually and stain with
SP-10 / SP-50 with dedicated staining protocol

For example:
samples with high WBC need Smear
increased staining time manually

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Sysmex Systematization Benefits

Automating
process removes
Standardization
manual errors by promoting
standardization, consistency
for better quality

Lab operates more efficiently


Efficiency
Clinical parameters that provide where staff can focus on other tasks
Informative
additional / early information
for better patient outcome

User definable rules for


Customization
rerun/reflex to make a slide and
staining protocols.

Additional analysers and licenses


can be added as the workload
Upgradability
increases - available for future
expansion

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Further integrations available

SP-50

DI-60 XN-10 / XN-20

The solution you have been waiting for…


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Challenges in Morphology Analysis

Long Turn-Around-Time (TAT)


• Tedious workflow in the laboratory – time
High risk of Human Error consuming or reporting?
• Mis-labelling
Subjectivity of morphology analysis • Duration per morphology analysis: ± 5-10
mins
Varying morphology skills capability
• Unable
If not all slides can be reviewed on the same
to view the same cells
No standardization in the analysis Lack of traceability
day, it’ll be carried over to next day.. again
and again..

What if,
second opinion is needed?

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Sysmex DI-60

Sysmex DI-60 enables laboratories to automate, standardize and simplify


morphological examination of peripheral blood smears. The application supports:

WBC Differential: RBC Review: Platelet Review:

Comprehensive pre- Pre-characterization Platelet estimation


classification into 17 based on 6
cell types morphological
characteristics

Throughput

Peripheral Blood (100 WBC+RBC+PLT):


Up to 30 slides per hour

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Conclusions

• XN-1500 is a compact systematization solution to provide


standardization to the slide making and provide clinical values
on par with higher systematization system
• Modular concept provides solution with better flexibility and
more variety to meet customers with different needs
• DI-60 to achieve standardization in morphology analysis with
digital data archiving that allow e-consultation to experts and
better data management
• Support laboratory accreditation with standardized process
and all analysis information in the instrument

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