Hematology Application

DYMIND
Professional IVD Solution Innovator
Solution Innovator Content
1 Hematology Summarization
Professional IVD

2 Hematology Analysis

3 Hematology Components

4 Technology Application
 ABOUT US

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Professional IVD
Solution Innovator

1 Hematology Summarization
 What is hematology?

Hematology is the branch of internal medicine,

physiology, pathology, clinical laboratory work,
and pediatrics that is concerned with the study
of blood, the blood-forming organs, and blood
diseases.  -------Wikipedia
Clinical application

Make a DIAGNOSIS
MONITOR the course of a disease
Establish BASELINE status of patient for subsequent comparison
SCREEN for health or a disease
Development history

Before 1674 Leeuwenhoek Microscope

Macro World
Leewenhuek A. Microscopical Observations. Philos Trans R Soc Lond. 1674

1674 Paul Ehrlich

aniline dyes

Ehilich P. Beitrag zur Kennitnis der Anilinfarbungen und iher Verwendung in der
1674 mikroskopichen Technik. Arch Mikr Anat. 1877

Micro 1877 Wallace Coulter

Coulter Impedance
World
1956

1956
First automated analyzer
Coulter WH. High sped automatic blood cell counter and cell size analyzer. Proc National
Electronics Conf. 1956
TECHNICAL LEADER

Pioneer Creator of the algorithm of first-generation of 5-Part

hematology analyzer

National 863 Program Leader of the national project on the theme of

Development of the New Generation of High-
performance 5-Part Hematology Analysis System

Leader of Peacock Project to build a world-class industrial

The Peacock Project
innovation team for cell analysis

Innovator of China's first high-end 5-Part hematology

Trailblazer analyzer with fully independent intellectual property
rights
Ziling Huo, COO
Development history

1960 Multi-parameter CBC

~~ analyzer
1979

3 part Hematology
Analyzer (HA)
1980
~~
Year of HA
Golden

1999
5 part HA

Automatic HA with Retic and

NRBC tests
2000
~~
HA Streamline

2013 Dymind
research and develop independently
Development history

PARAMETER MANUAL AUTOMATED

Improved test efficiency Hemoglobin (Hb) 3.3 % 1.0 - 2.3 %
Hematocrit (PCV) 3.8 % 1.1 - 3.8 %
Improved Red Cell Count (RBC) 20.4 % 1.0 - 2.7 %
precision White Cell Count (WBC) 17.0 % 1.7 - 4.4 %
- Granulocytes % (N+E+B) 8.0 % 3.0 %
- Lymphocytes % (L) 17.0 % 5.0 %
- Monocytes % (M) 35.0 % 12.0 %
Platelet Count (PLT) 23.0 - 25.0 % 4.0 - 10.0 %
Ref. John Koepke,1991
based on the College of American Pathologists (CAP) survey

Microscope, once the main tool for cell counting & morphological analysis, still very
far from being replaced!
Professional IVD
Solution Innovator

2 Hematology Analysis
Blood Draw

Whole Blood Draw Capillary Blood Draw

from arm veins from finger tips or ear drops
When do we have to do capillary blood draw?
When do we have to do capillary blood draw?

Newborns and the elderly who have difficulty drawing blood;  

Critically ill patients with unwell blood drawing;  
Special clinical needs;  
The results are relatively inaccurate and the error is relatively large. 

Advantage  Disadvantage
Convenient  Test results are relatively easily interfered
Less sample volume
 
Blood draw

EDTA-K2 is recommended by ICSH and CLSI.

The recommend concentration is 1.5 - 2.0 mg/ml.

Follow the blood collection volume specified by the tube

manufacturer to get a proper anticoagulation.
Blood draw

Things to concern before whole blood sample

Thorough mixing, usually by inverting tubes 8-10 times, is critical for

proper anticoagulation.

Please use clean EDTAK2 or EDTAK3 anticoagulant collection tubes

to collect venous blood samples, and be sure to collect at least 0.5
mL of blood every time.

Finish sample test within 8 hours (24 hours in fridge). Improper

concentration or longer EDTA treatment can introduce blood cell
morphology change.
Blood draw

Things to concern before capillary whole blood sample

Thorough mixing, usually by inverting tubes 8-10 times, is critical for

proper anticoagulation.

Please use clean EDTAK2 or EDTAK3 anticoagulant collection tubes

to collect capillary blood samples, and be sure to collect at least
120uL of capillary blood every time.

Please run the capillary whole blood sample within 3 minutes to 2

hours after collection.
Blood draw

Things to concern before pre-diluted sample

Thorough mixing, usually by inverting tubes 8-10 times.

After mixing the capillary sample with diluent, be sure to wait 5

minutes and then remix before running the sample.

Be sure to run the pre-diluted sample within 30 minutes after mixing.

Microscopic Examination

Golden standard for WBC differentiation

High time cost : 15~20mins per sample

Smear Plate

Staining
Microscopic
Examination
Professional IVD
Solution Innovator

3 Hematology Components
Hematology Components

WBC:
Participate in immunization response

RBC:
Transport oxygen from lung to body’s
organs and tissue

PLT :
Help blood coagulation if any tissue
damage
RBC
RBC

Shape: Concave disk

Size: 82-95 fL

Number: 4.0-5.5 x 1012/L

Function: Contains hemoglobin which is responsible

for carrying out O2 through human body.
Hematology Components

NUMBER RBC Cell number of RBC

MCV Mean cell volume of RBC

SIZE HCT Hematocrit

RDW -
Red blood cell distribution width
SD/CV

HGB Hemoglobin concentration

HGB
concentration MCH Mean corpuscular hemoglobin

MCHC Mean corpuscular hemoglobin

concentration
RBC

Normal “Loss” Anisocytosis Hypochromia

RBC HCT RDW HGB MCHC

MCH
Microcyte

MCV http://www.med.univ-angers.fr/discipline/lab_hema/morphogrweb/webmorphohematie.html
RBC

The number, size and hemoglobin concentration of RBC have clinical correlation with anemia, a symptom
featured by reduced ability of blood to carry oxygen.
According to WHO estimation, 2 billion people worldwide are suffering from anemia*. Anemia may
contribute to up to 20% of maternal deaths.

To diagnose details of anemia, 4 steps are usually needed:

B
• ESR o
•
• RBC • O Ferri n
C • HCT R RET T tin e
• HGB # •
B • MCV E • RET H Seru M
C • RDW T % E m ar
• … • …
R iron -
• … ro
* WHO. Turning the tide of malnutrition: responding to the challenge of the 21st century. Geneva: WHO, 2000 (WHO/NHD.007)

w
PLT
红细胞 RBC
PLT

Shape: Small, irregularly

Size: 7-11 fL

Number: 100-300 x 10 /L 9

Function: Involved in hemostasis,

leading to the formation of blood clots.
PLT

PLT Cell number of Platelet

NUMBER P-LCC Cell number of Large Platelet

P-LCR Cell ratio of Large Platelet

MPV Mean cell volume of PLT

SIZE PCT Plateletcrit

PDW Platelet distribution width

红细胞
WBC RBC
WBC

White Blood Cell

Neutrophil Eosinophil Basophil Monocyte Lymphocyte

Neutrophil
Neutrophil

Reference range:
 50%-70%

Morphology character:
 The nuclear is separated with 3-5 segments
 The cytoplasm is light-red with plenty
purple-red granules

Function:
 Leading the immunization response to
infection and killing bacteria function.
Neutrophil

Increase Neutrophil (Neutrophila) may indicate:

 Infection, most likely bacterial

 Noninfectious inflammation
 Injury
 Chronic leukemia
 …
Decrease Neutrophil (Neutropenia) may indicate:

 Severe infections(sepsis)
 Bone marrow suppression due to drugs,
chemotherapy, radiation, or infection.
 Aplastic anemia
 HIV/AIDS
 Leukemia
 …
Lymphocyte

Reference range:
 20%-40%

Morphology character:
 The nuclear is round or pitted
 The cytoplasm is pale blue with a few
granules

Function:
 Participating humoral immunity and
cellular immunity
Lymphocyte

Increase Lymphocyte (Lymphocytosis) may indicate:

 Acute virus infection

 Recovery of acute contagion
 Blood cancers, such as leukemia or lymphoma
 Rejection reaction after organ transplantation.
 …

Decrease Lymphocyte (Lymphocytopenia) may

indicate :

 HIV
 Bone marrow damage
 Autoimmune disorders, like lupus
 …
Monocyte

Reference range:
 3%-8%

Morphology character:
 The nuclear is reniform, horseshoe or irregular
 The cytoplasm is grayish blue with fine
purplish red granules

Function:
 Swallowing bacteria or cells, submitting
antigens and activating lymphocytes, etc.
Monocyte

Increase Monocyte (Monocytosis) may indicate:

 Long standing infections

 Chronic inflammatory disorders
 Infectious mononucleosis
 Some forms of leukemia
 …
Decrease Monocyte (Monocytopenia) may indicate :

 Bone marrow damage/failure

 Hairy cell leukemia
 …
Eosinophil

Reference range:
 0.5%-5%

Morphology character:
 The nuclear is separated 2 segments
 The cytoplasm owns thick, orange
granules

Function:
 Destroying invading germs like viruses,
bacteria, or parasites and negative
adjusting allergic reaction
Basophil

Reference range:
 0%-1%

Morphology character:
 The nuclear shows unclear segment
 The cytoplasm is pale orange with a
few blue-black granules Eosiphil

Function:
 Preventing blood clotting,
Mediating allergic reactions
Eosinophil & Basophil

Increase Eosinophils (Eosinophilia) may indicate:

 Allergies
 Parasitic infections
 Some types of cancers

Increase basophils (Basophilia) may indicate:

 Allergies
 Some cancers and inflammatory disorders
Others

Appearance of Nuclear RBC may indicate:

 Anemia
 Server blood system disease
 …

Appearance of Abnormal Lymphcyte may indicate:

 Virus infection
 Immune disease, allergy
 …

Appearance of Large Immature Cell may

indicate:

 Acute or chronic leukemia,

 Bone marrow disease or canner
 .…
Professional IVD
Solution Innovator

4 Technology Application
3-Part

LYM Lymph

MON

EOS MID 3-Part

BAS

NEU GRA
3-Part

Size
A C

D E

Granules
5-Part

Neu Eos Bas Mon Lym

Principle

Using different kinds Because of sheath Light scattering

of lyses to change fluid, the blood cells occurs when a
the properties of are passing through particle deflects laser
blood cells the counting aperture light. The extent to
in single file. which this occurs
depends on the
physical properties of
the particle.
Advanced Flow Cytometry (FCM)

Ensure every cell goes through the flow cell one by one.
Tri-angle Laser Scatter

Cellular complexity

HS: High angle scatter

Cellular granularity

MS: Middle angle scatter

Cell volume

LS: Low angle scatter

DIFF Channel

RBC RBC

LS
LYMM LYM

Lyse2
LS
MON
MON

HS
NEU NEU

HS
EOS EOS
DIFF Channel

LS LS

Cell Volume

Cell Volume
LYSE2
MS
Granularity Granularity MS

RBC RBC
LYM LYM
MON MON
NEU NEU
EOS EOS
DIFF Channel

MON%

NEU%

EOS%

LYM%
DIFF Channel

Distinct Diff

LS
MON&NEU Overlapped MON
NEU

EOS

LYM &MON Overlapped LYM

HS
MS

2D-scattergrams 3D-scattergrams
RBC/PLT Channel

Impedance
RBC/PLT Channel

U=R*I
aperture When cell passing through the aperture by vacuum, it
will introduce the change on resistance. In a constant
+ - current, the voltage change signal will be recorded
and accords with the volume of cell.
vacuum
electrode

DC Impedance
RBC/PLT Channel

100fL

50fL

15fL

Number

DC Impedance

Histogram

15 50 100 fL
Baso/HGB Channel

Laser scatter and Colorimetry

Baso/HGB Channel

RBC RBC

LYSE1
Other WBC

BASO

BA BA
S S

Other Other
WBC WBC
Baso/HGB Channel

Ly
se
Baso/HGB Channel

Lambert Beer’s Law

HGB
MCH
MCHC

Fe 2+ Fe 3+
＋ Fe 2+ Fe 3+
Fe 2+ Fe 3+
Fe 2+ Fe 3+
Anionic surfactant
Thank you
Email: intl@dymind.com
Website: www.dymind.com