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John Bleby Sysmex UK XN WPC Channel How it works and the UK experience

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Page 1: XN WPC Channel - Sysmex€¦ · XN WPC Channel 11 White Precursor Cell (WPC) screening identifies abnormal white blood cells through the detection of an abnormal lipid composition

John Bleby – Sysmex UK

XN WPC Channel

How it works and the UK experience

Page 2: XN WPC Channel - Sysmex€¦ · XN WPC Channel 11 White Precursor Cell (WPC) screening identifies abnormal white blood cells through the detection of an abnormal lipid composition

Agenda

01

02 What is the WPC Channel?

04

03 How does it work?

XN in the UK and Ireland

Case studies and Performance

Agenda

01

Page 3: XN WPC Channel - Sysmex€¦ · XN WPC Channel 11 White Precursor Cell (WPC) screening identifies abnormal white blood cells through the detection of an abnormal lipid composition

XN in the UK and Ireland

Page 4: XN WPC Channel - Sysmex€¦ · XN WPC Channel 11 White Precursor Cell (WPC) screening identifies abnormal white blood cells through the detection of an abnormal lipid composition

XN Installations in the UK & Ireland

4

Page 5: XN WPC Channel - Sysmex€¦ · XN WPC Channel 11 White Precursor Cell (WPC) screening identifies abnormal white blood cells through the detection of an abnormal lipid composition

UK Market Situation

5

250 XN Series at 83 sites

(25 XN-20) 241 XE Series

(+80 XT)

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UK XN App Sales

6

250 XN Analysers

90 Ret Licences

42 PLT-F Licences

34 BF Licences

25 WPC

Page 7: XN WPC Channel - Sysmex€¦ · XN WPC Channel 11 White Precursor Cell (WPC) screening identifies abnormal white blood cells through the detection of an abnormal lipid composition

What is the WPC Channel?

Page 8: XN WPC Channel - Sysmex€¦ · XN WPC Channel 11 White Precursor Cell (WPC) screening identifies abnormal white blood cells through the detection of an abnormal lipid composition

XN WPC Channel

The XN WPC channel is an extended

differential counting and flagging system.

Composed of additional:

• Hardware

• Software

• Reagents

Page 9: XN WPC Channel - Sysmex€¦ · XN WPC Channel 11 White Precursor Cell (WPC) screening identifies abnormal white blood cells through the detection of an abnormal lipid composition

Act as a team

• 9

» Maximum sensitivity

» Preclassification of clear cases

» Increased specificity

» Reduction of false positives

» Final classification reactive and malignant

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XN WPC Channel

10

Hardware

The WPC application comes as standard

on the XN 20 unit, but is unavailable on

the XN 10. There is no ability to upgrade

an XN-10 to XN-20.

Reagents

The WPC channel uses two reagents. A

Lysercell surfactant reagent to gain

access to the cell and a Flurocell to stain.

Page 11: XN WPC Channel - Sysmex€¦ · XN WPC Channel 11 White Precursor Cell (WPC) screening identifies abnormal white blood cells through the detection of an abnormal lipid composition

XN WPC Channel

11

White Precursor Cell (WPC) screening identifies abnormal white blood cells

through the detection of an abnormal lipid composition in the cell membranes,

and is thus able to separate them from normal WBC.

The trigger for this analysis is an abnormal finding in the initial CBC+DIFF

analysis and a special rule set for reflex testing.

Page 12: XN WPC Channel - Sysmex€¦ · XN WPC Channel 11 White Precursor Cell (WPC) screening identifies abnormal white blood cells through the detection of an abnormal lipid composition

How does it work?

Page 13: XN WPC Channel - Sysmex€¦ · XN WPC Channel 11 White Precursor Cell (WPC) screening identifies abnormal white blood cells through the detection of an abnormal lipid composition

XN WDF and WPC

• Automated reflex of WPC following CBC/Diff analysis means that

there is no staff interaction required in order to further investigate.

• The WPC testing is triggered following the production of the

Blast/Abn Lymphs? Flag from the WDF channel.

• These results are interpreted together to get the best possible

picture of what the abnormal cell population is composed of.

13

Page 14: XN WPC Channel - Sysmex€¦ · XN WPC Channel 11 White Precursor Cell (WPC) screening identifies abnormal white blood cells through the detection of an abnormal lipid composition

Working together

14

Fl

Vol.

SSC

SSC

WDF [lipid membrane & RNA content]

WPC [Lipid membrane & DNA content]

L

M

N E

L M

N E

L

M N E

L

M N E

L

L

Fl

Vol.

SSC

SSC

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XN Flagging Strategy

16

Page 16: XN WPC Channel - Sysmex€¦ · XN WPC Channel 11 White Precursor Cell (WPC) screening identifies abnormal white blood cells through the detection of an abnormal lipid composition

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Page 17: XN WPC Channel - Sysmex€¦ · XN WPC Channel 11 White Precursor Cell (WPC) screening identifies abnormal white blood cells through the detection of an abnormal lipid composition

Case Studies and Performance

Page 18: XN WPC Channel - Sysmex€¦ · XN WPC Channel 11 White Precursor Cell (WPC) screening identifies abnormal white blood cells through the detection of an abnormal lipid composition

Case studies

19

Patient history: Lymphocytosis in a 53-year old woman.

Page 19: XN WPC Channel - Sysmex€¦ · XN WPC Channel 11 White Precursor Cell (WPC) screening identifies abnormal white blood cells through the detection of an abnormal lipid composition

Case studies

20

Diagnosis:

B-cell chronic lymphatic leukaemia (B-CLL)

Population of abnormal

Lymphocytes in SSC/SFL

WPC Channel

Page 20: XN WPC Channel - Sysmex€¦ · XN WPC Channel 11 White Precursor Cell (WPC) screening identifies abnormal white blood cells through the detection of an abnormal lipid composition

Case studies

Patient history: 54-year old man was admitted to the

hospital with a high fever.

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Page 21: XN WPC Channel - Sysmex€¦ · XN WPC Channel 11 White Precursor Cell (WPC) screening identifies abnormal white blood cells through the detection of an abnormal lipid composition

Case studies

22

Diagnosis: Acute myeloid leukaemia (AML) under chemotherapy: AML with

abnormal marrow eosinophils

Population of Blasts in WDF/WPC Channel

Page 22: XN WPC Channel - Sysmex€¦ · XN WPC Channel 11 White Precursor Cell (WPC) screening identifies abnormal white blood cells through the detection of an abnormal lipid composition

Case studies

23

Patient history: a patient with a known disease, undergoing treatment.

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Case studies

24

Diagnosis:

A 63-year old male patient suffering from mantle cell lymphoma had undergone

chemotherapy and his blood was examined to monitor the effect of the

treatment.

Population of abnormal lymphocytes in WDF/WPC Channel

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XN WDF vs XE-5000

25

Jones AS, Tailor H, Liesner R, Machin SJ, Briggs CJ (2014).

The value of the white precursor cell channel (WPC) on the Sysmex XN-1000 analyser in a specialist

paediatric hospital. J Clin Pathol 68(2): 161

Page 25: XN WPC Channel - Sysmex€¦ · XN WPC Channel 11 White Precursor Cell (WPC) screening identifies abnormal white blood cells through the detection of an abnormal lipid composition

XN WDF+WPC vs XE-5000

26

Page 26: XN WPC Channel - Sysmex€¦ · XN WPC Channel 11 White Precursor Cell (WPC) screening identifies abnormal white blood cells through the detection of an abnormal lipid composition

Munich Großhadern Studies

27 27

Accepted in: Clinical Chemistry and Laboratory Medicine (CCLM, Feb.2015)

Page 27: XN WPC Channel - Sysmex€¦ · XN WPC Channel 11 White Precursor Cell (WPC) screening identifies abnormal white blood cells through the detection of an abnormal lipid composition

Any Questions?

Page 28: XN WPC Channel - Sysmex€¦ · XN WPC Channel 11 White Precursor Cell (WPC) screening identifies abnormal white blood cells through the detection of an abnormal lipid composition