XN Series Technology

XN-Series Technology
“What’s Inside the Box?”
© 2015 Sysmex America, Inc. All rights reserved.
OBJECTIVES
Describe the technologies available on the

XN-Series and the reason(s) for selection
Utilize example case studies to illustrate

the new capabilities of PLT-F technology
used on the XN-Series
Describe the advanced reagent technology

of the RU-20
1
Accuracy
BEYOND TECHNOLOGY
BEYOND EXPECTATIONS
Dependability
Quality
NEXT ADVANCED
GENERATION TOOLS &
DIAGNOSTICS TECHNOLOGIES
greater accuracy, superior insight and
specificity, productivity control, enhancing
speed to treatment
HARMONIZED
PROCESS
SUPPORT
OPTIMIZATION
driving improvement,
automatically
supporting your staff,
balances work-flow
helping you plan for
and routine tasks
the future
NEXT ADVANCED
GENERATION TOOLS &
DIAGNOSTICS TECHNOLOGIES
greater accuracy, superior insight and
specificity, productivity control, enhancing
speed to treatment
2
THE MOST ADVANCED HEMATOLOGY
DIAGNOSTICS ON THE MARKET
Advanced
Body Fluid
Clinical
Differentials
Parameters
Rerun/Reflex Fluorescent
Testing Platelet
XN-SERIES
Same Analytical Module

Up to 100 /hr /module
Common Software System
Common Reagent System
Common QC System
XN-1000 XN-3000 XN-9000

SA-01 XN-1000 XN-2000
3
N E X T G E N E R AT I O N D I A G N O S T I C S
SINGLE MODULE – FULLY LOADED
Every XN Configuration can

include:
All the parameters
All the features
All the capabilities
EXCEPTIONS TO THE RULE:

SA-01 SAMPLER
XN WITH SA-01 SAMPLER OPTIONS
4
SA-01 SAMPLER VERSUS SA-10
SA‐01 SA‐10
Smart Start

Reflex/Rerun capabilities 
Rack bar code read
capability 
MAP tubes in rack mode 
MAP tubes in manual
mode  
My Sysmex Compatible  
XN-Series Technology
SYSMEX XE VS. XN TECHNOLOGY
RBC,
WBC / RET /
PLT, NRBC DIFF
BASO PLT‐O
Hgb
RBC,
PLT, WNR WDF RET PLT‐F
Hgb
NEW NEW NEW
5
SYSMEX FOUNDATIONAL TECHNOLOGY
RBC & Platelet

DC Detection / Hydrodynamic
Focusing
Hemoglobin
Absorbance / Sulfolyser
RBC & PLATELET
Reportable Parameters
RBC
Platelets
Reagents
CELLPACK DCL
CELLPACK DST*
*Used with RU-20
FLUORESCENT FLOW CYTOMETRY
Side Fluorescent Light

DNA/RNA information
Side Scattered Light

Dichroic Mirror Cell inside structure information
Forward Scattered Light

Cell size information
Laser Beam
wavelength=633nm
6
WNR channel WDF channel PLT-F channel RET channel
WNR Channel
White Cells, NRBCs
WNR CHANNEL
BASO LYMPH MONO Granulocyte
NRBC RBC
Polymethine Dye
7
WNR CHANNEL
FSC
BASO
NRBC
WBC
Debris
SFL
ADVANTAGE OF FLUOROCELL WNR

FSC
SFL SFL
NRBC CORRELATION DATA
Correlation Coefficient (R) = 0.9219 Correlation Coefficient (R) = 0.9179

N = 171 N = 171
Data from the University of Iowa / Dec 2011
8
MEGAKARYOCYTES
MEGAKARYOCYTES
WNR CHANNEL
Fluorescent Flow Cytometry Technology

Maximized Efficiency
NRBC the first time – all the time
No additional steps
Accurate WBC Counts in the presence of NRBCs
No additional reagent needed
Virtually eliminates interference from:
Lyse resistant RBCs
Lipids
9
WDF Channel
WBC Differentials by Fluorescence
WDF CHANNEL
LYMPH MONO NEUT EO
Atypical LYMPH Immature WBC
Polymethine Dye
WDF CHANNEL
MONO
IG
LYMPH
NEUT+BASO
Debris
EO
10
IG – XN DIFF ABSTRACT
ENHANCED FLAGGING ALGORITHMS
SAFLAS method
(Sysmex Adaptive Flagging Algorithm

based on Shape-recognition)
Detects abnormal cells - (with high sensitivity)

LDA (Linear Discriminant Analysis)
WDF SAFLAS METHOD

Normal Abnormal (Blasts?) Abnormal (Abn Lympho?)
11
WDF CHANNEL
Enhanced Flagging
Better separation between lymphs and monos (SAFLAS)
Better identification of platelet clumps (multiple channel
detection)
Auto-correction of lymphs when NRBCs are present
6-part differential (including IG)
Copyright © 2012 by Sysmex America, Inc. All rights reserved.
LOW WBC ANALYSIS MODE
WB (Whole Blood) mode LW (Low WBC) mode
Dilution Rate : x 61.1 Dilution Rate : x 61.1

Analysis Volume : 58.2µL Analysis Volume : 174.6µL
Whole Counts *2 : 9,530 Whole Counts *2 : 28,600
Analysis Time extended to 3 times the Whole Blood WBC count time
LOW WBC ANALYSIS MODE
Analysis time extended to 3 times WB WBC count time
Better accuracy and precision on

counts < 0.50 x 103
No Vote Outs – Differential results on all counts
Increased reportable differentials
12
Body Fluid Analysis
Using RBC/PLT & WDF Channels
BODY FLUID ANALYSIS
Body fluid mode (target species)
HF-BF Cerebrospinal fluid (CSF)
Pleural fluid
MN
Peritoneal fluid
MO-BF
LY-BF Synovial fluid

PMN
NE-BF
EO-BF
WDF Scattergram
BODY FLUID ANALYSIS
No pre-analysis preparation
No additional reagents
Automated background counts
Rapid analysis
13
PLT-F Channel
PLaTelets by Fluorescence
PLT-F CHANNEL
Impedance platelet analysis (size) has limitations

Identification and discrimination of platelets from interfering
particles with the same size
Possible interferences
RBC or WBC fragments counted as platelets: falsely high
Microcytic RBCs counted as platelets: falsely high
Large platelets counted as RBC: falsely low
PLT-F CHANNEL
RBC PLT IPF
Oxazine Dye
14
PLT-F CHANNEL
RBC IPF
PLT-F
SEPARATING PLATELETS FROM

RBC FRAGMENTS
Platelet
RBC
Fragment
Transmitted
light
• CD41/CD61 positive ＝ Platelets
• Staining by PLT‐F dedicated reagent
– Platelets ‐ Strong, especially within the cell
– RBC fragments ‐ Weak, only cell membrane
CD61/PLT-F
GIANT PLATELETS & PLT-F
15
DxH 800 Platelet 114
Manual plt estimate 200
DxH 800 Platelet 114

Manual plt estimate 200
INTERFERENCE WITH ROUTINE

IMPEDANCE COUNT
ß-Thalassemia Major with numerous fragmented red cells
XE: PLT-I XE: PLT-O XN: PLT-F

PLT-I Microcytic RBC
Microcytic
Microcytic RBC RBC
XE XN
PLT-I = 477*109/L PLT-I = 514*109/L
PLT-0 = 111*109/L PLT-F = 140.8*109/L
PLT-CD61 =152.2*109/L PLT-CD61 = 152.2*109/L
IPF% = 13.9% IPF%= 12.9%
16
IMPROVED PERFORMANCE OF PLT-F
Acute Promyelocytic Leukemia / chemo: white blood cell fragments
XE: PLT- O XN: PLT-F
WBC cytoplasm
WBC cytoplasm
fragments
fragments
IPF
XE PLT-F
XN
PLT-I = 25*109/L
PLT-I = 28*109/L
PLT-0 = 181*109/L
PLT-F = 24.2*109/L
PLT-CD61 = 24.2*109/L
PLT-CD61 = 24.2*109/L
IPF% = 41.2%
IPF% = 1.1%
IPF# = 74.6*109/L
IPF# = 0.3*109/L
PLT MEASUREMENT OVER TIME IN A

SEVERE BURN INJURY PATIENT
The feature:
Huge micro-spherical FRCs appeared because of heat shock.
PLT COUNT OVER TIME IN A SEVERE

BURN INJURY PATIENT
Day 1
PLT-F
PLT
(x10^3/uL)
PLT-I 1118 PLT-I
PLT-F 228
CD61 204
Day 2
PLT-F
PLT
(x10^3/uL)
PLT-I
PLT-I 795
PLT-F 161
CD61 150
17
PLT COUNT OVER TIME IN A SEVERE
BURN INJURY PATIENT
Day 3
PLT-F
PLT
(x10^3/uL)
PLT-I 632 PLT-I
PLT-F 116
CD61 115
Day 4
PLT-F
PLT
(x10^3/uL)
PLT-I
PLT-I 201
PLT-F 54
CD61 51
PLT-F CHANNEL
Second method of platelet
Fluorescent Dye specific for platelet organelle

Extended count time (6 times) for accurate platelet enumeration,
especially in low platelet counts
Good comparison with CD41/CD61
Minimizes interference from RBC fragments, microcytic

RBC’s and WBC fragments
Automated reflex with on board rules

“BPR systems” only
RET Channel
RETiculocytes, IRF, RET-He
18
RET CHANNEL
WBC RET RBC PLT
Polymethine Dye
RET CHANNEL
RET
LFR MFR HFR

RBC
IRF
PLT
RETICULOCYTE PARAMETERS
• Reticulocytes
– # and % of immature RBC’s
• Immature Reticulocyte
Fraction
– Newly released from the
marrow, a direct cellular
measurement of
erythropoiesis
• Reticulocyte Hemoglobin
– Direct cellular measure of iron
availability
19
RETICULOCYTE CHANNEL
Operational Efficiency
Reduced Interference From:
WBCs
Howell Jolley Bodies
Parasites
Sickle cells
Quick and automatic
Monitor RBC development at the cellular level

IRF for Retic production
RET-He for iron incorporation in hemoglobin of the erythron
Clinically relevant information for the management of anemia

in conjunction with other available clinical information.
Summary
W
N
BASO LYMPH MONO Granulocyte NRBC RBC
R
W
D
F
LYMPH MONO NEUT EO Atypical LYMPH Immature WBC
R P
E L
T WBC RET RBC PLT T RBC PLT IPF
20
XN TECHNOLOGY SUMMARY
WNR Channel WDF Channel

Maximized efficiency Enhanced Flagging
NRBC the first time – all 6-part differential
the time (including IG)
Accurate WBC Counts in Improved Sensitivity and
the presence of NRBCs Specificity
XN TECHNOLOGY SUMMARY
Low WBC PLT-F

Better accuracy and Fluorescent Dye specific
precision on counts < 0.50 for platelet organelle
x 103 Extended count time (6
No Vote Outs – Differential times) for accurate low
results on all counts platelet enumeration
Increased Reportable Good comparison with
differentials CD41/CD61
Automated reflex with on
board rules
THE “SO WHAT?”
WNR Channel WDF Channel
• NRBCs on every CBC • 6‐Part Diff
• No WBC Correction • Diffs on low WBC
• IG % & #
Highly capable technology

with a singular goal:
Reduce bottlenecks to
Improve TAT while
Adding clinical value
RET Channel PLT‐F Channel
• RET, IRF & RET‐He • Robust 2o Method
• Production View • Reflexive, with IPF
• Functional View • No operator interaction
necessary
21
XN Technology
Reagents – RU-20
SMART REAGENT MANAGEMENT SYSTEM
RU-20 Reagent Management System

25x concentrate
Reduces reagent changes and instrument idle time
Increases free space in the lab.
CELLPACK DCL compared with RU-20 and CELLPACK DST

WHY IT MATTERS……
1 cube of diluent weighs ~48lbs

At 300 samples/day you move about 156 cubes/year
RU-20 = 1 cube/50 days

~7.2 cubes/year
Model that over 5 years

With an average of 3 physical moves of each cube
22
WHY IT MATTERS……
Now You Know What’s Inside the

Box
Thank You
23

XN Series Technology

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XN-Series Technology

“What’s Inside the Box?”

© 2015 Sysmex America, Inc. All rights reserved.

Describe the technologies available on the

Utilize example case studies to illustrate

Describe the advanced reagent technology

© 2015 Sysmex America, Inc. All rights reserved.

© 2015 Sysmex America, Inc. All rights reserved.

© 2015 Sysmex America, Inc. All rights reserved.

© 2015 Sysmex America, Inc. All rights reserved.

© 2015 Sysmex America, Inc. All rights reserved.

© 2015 Sysmex America, Inc. All rights reserved.

Same Analytical Module

XN-1000 XN-3000 XN-9000

© 2015 Sysmex America, Inc. All rights reserved.

SINGLE MODULE – FULLY LOADED

Every XN Configuration can

© 2015 Sysmex America, Inc. All rights reserved.

EXCEPTIONS TO THE RULE:

© 2015 Sysmex America, Inc. All rights reserved.

XN WITH SA-01 SAMPLER OPTIONS

© 2015 Sysmex America, Inc. All rights reserved.

© 2015 Sysmex America, Inc. All rights reserved.

SYSMEX XE VS. XN TECHNOLOGY

NEW NEW NEW

© 2015 Sysmex America, Inc. All rights reserved.

SYSMEX FOUNDATIONAL TECHNOLOGY

RBC & Platelet

© 2015 Sysmex America, Inc. All rights reserved.

RBC & PLATELET

© 2015 Sysmex America, Inc. All rights reserved.

FLUORESCENT FLOW CYTOMETRY

Side Fluorescent Light

Side Scattered Light

Forward Scattered Light

© 2015 Sysmex America, Inc. All rights reserved.

FLUORESCENT FLOW CYTOMETRY

WNR channel WDF channel PLT-F channel RET channel

© 2015 Sysmex America, Inc. All rights reserved.

© 2015 Sysmex America, Inc. All rights reserved.

BASO LYMPH MONO Granulocyte

ADVANTAGE OF FLUOROCELL WNR

© 2015 Sysmex America, Inc. All rights reserved.

NRBC CORRELATION DATA

Correlation Coefficient (R) = 0.9219 Correlation Coefficient (R) = 0.9179

Data from the University of Iowa / Dec 2011

© 2015 Sysmex America, Inc. All rights reserved.

© 2015 Sysmex America, Inc. All rights reserved.

© 2015 Sysmex America, Inc. All rights reserved.

Fluorescent Flow Cytometry Technology

© 2015 Sysmex America, Inc. All rights reserved.

© 2015 Sysmex America, Inc. All rights reserved.

LYMPH MONO NEUT EO

Atypical LYMPH Immature WBC

© 2015 Sysmex America, Inc. All rights reserved.

ENHANCED FLAGGING ALGORITHMS

(Sysmex Adaptive Flagging Algorithm

Detects abnormal cells - (with high sensitivity)

© 2015 Sysmex America, Inc. All rights reserved.

WDF SAFLAS METHOD

© 2015 Sysmex America, Inc. All rights reserved.

Copyright © 2012 by Sysmex America, Inc. All rights reserved.

© 2015 Sysmex America, Inc. All rights reserved.

LOW WBC ANALYSIS MODE