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Sysmex XE-2100

Sysmex XE-2100. Flagging. F lag Messages. Negative No abnormality found Positive One ( or more) of the 39 IP messages generated Error Classified as either “func” or “result” error messages. POSITIVE. Diff. Abnormality in Cell Differential. Abnormality in Cell Morphology. Morph.

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Sysmex XE-2100

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  1. Sysmex XE-2100 Flagging

  2. FlagMessages • Negative • No abnormality found • Positive • One (or more) of the 39IP messages generated • Error • Classified as either “func” or “result” error messages

  3. POSITIVE Diff Abnormality in Cell Differential Abnormality in Cell Morphology Morph Abnormality in Cell Count Count ERROR Analysis error other than ID Barcode Func Result Low Reliability of Data Delta Abnormalities with Delta Check Positive and Error Messages

  4. Parameter Marks Marks Data Exceeding Reference Interval +,- Data Outside Numerical Range @ * Data is Doubtful Analysis can’t be done “----” Data exceeds display capability “++++” “ “ No order given Corrected Data &

  5. + - or Limit Flags • Mark limits • User definable categories and ranges • 7 age/sex related categories & 1 universal category • Flags results outside of user defined limits. • Critical limits • One set of user definable limits. • Flags results which fall outside of Critical limits. • Stop limits • One set of User definable limits • Flags results outside Stop limits, stops Instrument and Alarms (if set to do so) or -

  6. Interpretive Messages • Generated by a number of user definable and instrument generated criteria. • These can be: • values assigned by the user to particular flags • areas of abnormality found on the scattergrams or histograms.

  7. Interpretive Messages • Draw attention to abnormalities of the sample. • These flags may need confirmation • microscopic examination of a blood film • manual differential. • etc (?)

  8. WBC Flagging

  9. DIFF WBC/BASO IMI NRBC WBC Channels that generate flags

  10. NLME:WBC except BASO Bas/NLME Gst/NLME WBC ABN Scattergram Detected from dot counts on border line between cluster A and cluster B Ly/Ne2 Ly/Mo2 Mo/Eo Ly/Mo1 Mo/NE Ne/Eo Ly/Ne1 Ly/Ba Ly/Gst Ba/Gst Ne/Gst

  11. DIFF Channel – Abnormal Flags Fluorescence Side Scatter

  12. DIFF abnormal scattergram Promyelo Myelo Meta, Myelo Blast Band

  13. Immature Granulocytes ImmatureGranulocytes

  14. Platelet Clumps IMI Scattergram

  15. NRBC NRBC Channel NRBC Present

  16. Neutropenia Neutrophilia Lymphopenia Lymphocytosis Monocytosis Eosinophilia Basophilia Leukopenia Leukocytosis NRBC Present Only Appears if NRBC count performed Flagging WBC Abnormal (User defined)

  17. Flagging WBC Suspect • Blasts ? • Immature Gran ? • Left shift ? • Atypical lymph ? • ABN lymph/L-blasts ? • RBC lyse resistance ? • NRBC ?

  18. IMI DIFF Channels involved: IMI & DIFF Blasts/Atypical Lymph area in Diff Channel Blasts? Blasts area in IMI Channel WBC Suspect, BLASTS?

  19. DIFF Immature Granulocytes? IMI WBC Suspect, Immature Granulocyte?

  20. WBC Suspect, LEFT SHIFT ? DIFF LeftShift?

  21. WBC Suspect, Atypical LYMPH ? DIFF AtypicalLymph?

  22. WBC Suspect, ABN Lymph/ L-Blasts DIFF IMI Abn Lymph/L-Blasts?

  23. DIFF Channels involved: DIFF & NRBC NRBC? NRBC NRBC Present? WBC Suspect & Abnormal Flag, NRBC

  24. DIFF Channel involved: DIFF channel RBC Lyse Resistance? RBC Lyse Resistance ?

  25. RBC/Ret Suspect - Abnormal Flagging

  26. RBC_DC RET RBC/RET FlagAbnormal and Suspect • Channels which generate RBC/Ret IP flags are:

  27. RBCDC RBC Abnormal Distribution Computation of numerical data and size comparison • RBC Lower Discriminator (RL) • RBC Upper Discriminator (RU) • Multi Peak (MP) • RDW-SD not analysed (DW)

  28. RBCDC Dimorphic Population • Multi Peak flag (MP)

  29. RET-CH RET Abn Scattergram From UPP Count UPP=0.02x1012/l RET-CH (Extend)

  30. Flagging RBC/RET Abnormal • Anisocytosis • Microcytosis • Macrocytosis • Hypochromia • Anemia • Erythrocytosis • Reticulocytosis • All user definable

  31. Suspect Flags • RBC Agglutination • Computation of numerical data and size comparison • MCHC, MCH, RBC, RBC Upper Discriminator (%) • Turbidity/Hgb Interf • MCHC  36.5g/dL • Iron Deficiency • Computation of numerical data and size comparison • MCV, MCHC, RDW-CV • Hgb Defect • Computation of numerical data and size comparison • RDW-CV, MCV

  32. RBC/RET Suspect, Fragments Computation of numerical data and size comparison • RDW-SD • PLT Upper Discriminator • MCV • RBC Lower Discriminator • MCHC RBC Fragment # =550

  33. Platelet Suspect - Abnormal Flagging

  34. IMI DIFF RET(Plt-O) PLTDC RBCDC PLT Flags Abnormaland Suspect • Channels involved in generating flags are:

  35. PLT Abnormal Scatergram Detected from WBC fragment count RET-CH (PLT-O) WBC fragment # is =>20

  36. PLTDC PLT Abnormal Distribution Computation of numerical data and size comparison

  37. IMI DIFF PLT Suspect, PLT Clumps Channels involved: DIFF & IMI channels PLT Clumps?

  38. PLT Abnormal Flags • Thrombocytopenia • Thrombocytosis • Both user defined

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