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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 +

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

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




BF analysis is available on both XN types

Can be connected up to 9 units by license

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Fluoroscence Flowcytometry

Amount of RNA/DNA

Intracellular structure

88 uL
Cell size


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Flexible Configuration


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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

➢ Corrected WBCs are reported with high sensitivity and


➢ 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
Platelet RBC
➢ Support the differential diagnosis of thrombocytopenia and therapy

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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


• Standardized good quality of smear

• Turn-around-time
• Morphology skills

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A Good Quality Blood Smear
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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


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

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

Lab operates more efficiently

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

User definable rules for

rerun/reflex to make a slide and
staining protocols.

Additional analysers and licenses

can be added as the workload
increases - available for future

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Further integrations available


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
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


Peripheral Blood (100 WBC+RBC+PLT):

Up to 30 slides per hour

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• 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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