Automatic Haematology

Analyzer
Ahmad Mulyadi Sunarya
What to consider when buying a hematology
analyzer
The setting of use: patient bedside, consulting room, clinical lab, or
research lab.
Note that instruments must have regulatory approval for clinical as opposed
to research use
Range of tests
Time per analysis 
Automation
Reagent supply
Sample size and microsampling
Accuracy, precision, and linearity 
Maintenance, calibration, and QC
Results analysis and storage
Footprint
Abbott Cell-Dyn Ruby
XT-Series Two types of XT series

Model Parameter

XT-2000i CBC+DIFF+RET

XT-1800i CBC+DIFF

XT-2000i Launch
Schedule

XT-2000i XT-1800i

Release EU and AP: EU and AP:

Date February, 2002 May, 2002

US: US:
June, 2002 July, 2002
*after FDA approval *after FDA approval

Japan: Japan:
April, 2002 May, 2002

XT-2000i Launch
XT-2000i Parameters
33 Parameters
WBC, RBC, HGB, Hct, MCV, MCH, MCHC, PLT
RDW-CV, RDW-SD, MPV, PDW, P-LCR, PCT,
NEUT %, LYMPH %, MONO %, EO %, BASO %, IG %, NEUT #, LYMPH #,
MONO #, EO #, BASO #, IG #‚
RET %, RET #, LFR, MFR, HFR, IRF, PLT-fl

2 Histograms
RBC, PLT

5 Scattergrams
DIFF, WBC/BASO, RET, PLT-O, RET-EXT

XT-2000i Launch
Sample Volume
Capillary Blood 40 µl
Open Mode 85 µl
Manual Closed 150 µl
Automode 150 µl

XT-2000i Launch
Throughput
CBC 80 samples/h
CBC + Diff 80 samples/h
CBC + Diff + RET 80 samples/h
CBC + RET 80 samples/h

XT-2000i Launch
Reagent System
Name Abbreviation
Cellpack EBK
Sulfolyser SLS
Stromatolyser 4DS FFS
Stromatolyser FB FBA
Stromatolyser 4DL FFD
Ret Search 2 Dye RED
Ret Search 2 Lyse RED

XT-2000i Launch
XT-2000i Multi Channel Analyser
Whole blood sample

Analysis
Block RBC/PLT HGB WBC RET

Hydrodynamic Focusing Colorimetric Flow cytometry Flow cytometry

Principle - DC Detection - Determination

Analysis RBC/PLT HGB DIFF WBC/Ba RET

channel channel channel channel channel channel

PLT RBC DIFF WBC RET

Information scattergram scattergram
histogram histogram scattergram

Parameter PLT RBC HGB Lymph WBC# RET

Mono Baso
Neut+Ba PLT-O
EO IRF
*IG - research

XT-2000i Launch
XT-2000i Multi Channel Analyser
Channel Principle / Dilution Parameters

Flow Cytometry
WBC/BASO Diode laser - 1:50
WBC, Baso #‚ Baso %

Lymph #‚Lymph %,
Flow cytometry Mono #, Mono %,
4 Diff
Diode laser - 1:51 Eo #, Eo %,
Neut #‚ Neut %

Flow cytometry RET #, RET%, PLT-O

RET/PLT-O Diode laser - 1:204 HFR , MFR , LFR, IRF

SLS-Method, Photometry HGB

HGB
1:500

MCH, MCHC, MCV

HDF DC-Detection method RBC, HCT, PLT-I,

RBC/PLT-
Impulse summary RDW-SD, RDW-CV,
Detector 1:500 PDW, MPV, P-LCR

XT-2000i Launch
Fluorescence Flow Cytometry

Photo Multiplier
(Fluorescence Light)

Dichroic
Mirror

Photo Multiplier
(Side Scattered Light)

Semiconductor Laser
(l = 633nm)

Flow Cell

Photo Diode
(Forward Scattered Light)

XT-2000i Launch
Fluorescence Flow Cytometry
Side Fluorescence Light:
RNA/DNA Information
Side Scattered Light:
Internal Cell Structure

Forward Scattered Light:

Cell Volume Information

Laser Beam
(l = 633nm)

XT-2000i Launch
4 Diff-Channel Lyse & Staining
Polymethine : RNA, Oxazine : DNAEosinophil
Neutrophil Basophil Monocyte Lymphocyt
e

Band Metamyelocyte Myelocyte Promyelocyte Blast

Lyse & Staining

Neutrophil Eosinophil Basophil Monocyte Lymphocyt

e

Band Metamyelocyte Myelocyte Promyelocyte Blast

XT-2000i Launch
 XT
Flagging System
Flag
NEGATIVE
No abnormality

POSITIVE
One or more of the IP messages is generated

ERROR
Classified as Functional abnormality
Classified as Result, Low reliability

XT-2000i Launch
Flagging
POSITIVE

Diff Abnormality in Cell Differential

Morph Abnormality in Cell Morphology
Count Abnormality in Cell Count

ERROR

Func Analysis error other than ID Barcode

Result Low Reliability of Data
Delta Abnormalities with Delta Check

XT-2000i Launch
IP Message
Two Types
Abnormal IP Message:
Indicates that the sample is definitely abnormal. The IP
abnormal message criteria can be set except for some
items.
Suspect IP Message:
 Indicates that there is a possibility that the sample is
abnormal.

XT-2000i Launch
WBC Flagging
Abnormal
Suspect Messages
Messages

 Blasts?
WBC abnormal Scattergram
 Immature
Neutropenia Gran?
 Left
Neutrophilia
Shift?
 Atypical
Lymphopenia
Lympho?
 Abn
Lymphocytosis
Lympho/L-Blasts?
 RBC
Monocytosis
Lyse Resistance?
 NRBC?
Eosinophilia
 Basophilia
 Leukopenia
 Leukocytosis

XT-2000i Launch
RBC Flagging
Abnormal
Suspect Messages
Messages

 RBC Agglutination?
ABN Distribution
 Turbidity
Dimorphic/ HGB
Population
inter
 Iron
Ret ABN
Def?Scattergram
 HGB
Reticulocytosis
Defect?
 Fragments?
Anisocytosis
 Microcytosis
 Macrocytosis
 Hypochromasia
 Anaemia
 Erythrocytosis

XT-2000i Launch
PLT Flagging
Abnormal
Suspect Messages
Messages

 PLT ABN
ClumpsDistribution
?
 PLT ABN
C(s) ?Scattergram
 Thrombocytopenia
 Thrombocytosis

XT-2000i Launch
Features
Flowcytometry
Principle in Hematology

Resistance
Optical Measurement

XT-2000i Launch
Optical Principle

Scatter light
Information

Forward- Cell volume

scatter

Side- Granularity
scatter Internal Cell Structure

XT-2000i Launch
Optical Principle

Fluorescence
DNA/RNA-Content Cell cycles
Cell proliferation
Reticulocytes
Chromosome
..

XT-2000i Launch
Optical Principle
Light source:
 Tungsten lamp
 He-Ne laser
 Argon laser
 Semiconductor laser
Forward- Side-
scatter scatter Fluorescence
Tungsten lamp
 
He-Ne-Laser  
Argon laser
  
Semi conductor
laser   

XT-2000i Launch
Flowcytometry
Argon laser
 Wavelength l = 488 nm
Staining (RET)
 Acridine orange, Ethidium bromide, Thiazole orange,
Auramine O

Semiconductor Laser
 Wavelength l = 633 nm
Staining
 on basis of Polymethine for fluorescence optical detection
 with long stability and high fluorescence gain
 Fluorescence stimulation with semiconductor laser

XT-2000i Launch
Flowcytometry with XT-Series
What is so special?

Polymethine stains DNA/RNA, however important is

staining including RNA, and the use of these reagents make supra vital
staining possible.

Beside the information of

- Cell volume
- Intracellular components ,nucleus and granularity

we get also information about the Cell Activity

- Replication activity of the nucleus
(cause high RNA)
- Cytoplasm activity
(Protein syntheses causes high RNA)

XT-2000i Launch
IG Count
Useful information on WBC extended differential (Not
reportable - research parameter)

IG:
promyelocyte
myelocyte
metamyelocyte

Maturation of neutrophil

myeloblast promyelo myelo metamyelo band segment

IG
XT-2000i Launch
Summary
XT-2000i gives information about
replication activity of the nucleus (higher
RNA content)
XT-2000i gives information about
cytoplasm activity (Protein syntheses high
RNA)
Sub-population for B-lymphocytes.
Separates Lymphatic diseases from others
No problem with Giant-PLT or Fragments
(PLT-fl)
XT-2000i provide a total count of IG´s
(Sepsis)
XT-2000i Launch