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ABX welcomes the SIMeL April 29th, 2004 ABX Pentra DX 120 Conclusion
Mean features Leukopoïesis Erythropoïesis Thrombopoïesis Expert validation station ABX SPS evolution Conclusion ABX welcomes the SIMeL April 29th, 2004
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External view Rack loader Reagent compartment Processed tubes
Technical software Stat sample Bay Validation station Optional slide maker and stainer
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Main features 45 parameters Up to 120 samples / hour Optional and integrated slide maker and stainer Expert Validation Station
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Main features 8 types of analyses (with random access) CBC DIFF RET
CBR DIR ERB CBE SPS(*) (*): With SPS module
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Measurement principles overview
IMPEDANCE METHOD: RBC, PLT, WBC, BASO (specific lyse) PHOTOMETRY: HGB - Cyanmethemoglobin or cyanide free CYTOCHEMISTRY / IMPEDANCE: 5 DIFF + Immature lines FLUORESCENCE / IMPEDANCE: NRBC & RET
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Measurement principles overview
“D.H.S.S.” (HORIBA ABX patented) Double Hydrodynamic Sequential System 2 measurements points + Timing control (co%) Double hydrodynamic focusing to ensure a good measurement Sequential measurement to ensure that there is no clogging: -> Correlation Alarm
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Leukopoïesis exploration
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Leukopoïesis - WBC count
WBC channel Baso channel DIFF channel Triangulation Accurate alarms in case of discrepancy between channels
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Leukopoïesis - WBC count
WBC channel Double DIFF channel Baso channel ERB channel QuaDimension Corrected WBC count if Nrbc presence
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Focused Flow Impedance
Leukopoïesis - DIFF Focused Flow Impedance Measurement of the true cellular volume by impedancemetry after incubation with stabilizing reagent.
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+ Cytochemistry reaction Chlorazol Black Leukopoïesis - DIFF
Lyses of RBC Stabilises the WBC's in their native forms Differentially stains the leukocytes. Staining intensity is proportional to the nucleic acid quantity, to the maturity of this nucleic acid, to the lipids and enzyme quantity. The absorbance measurement is then proportional to the stain intensity.
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Tungsten lamp covers almost all wavelengths
Leukopoïesis - DIFF Light absorption Exploration of the cell internal structure which is proportional to the stain intensity Scattering Tungsten lamp covers almost all wavelengths Absorption Scattering High definition screening (Cell’s complexity is explored)
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Leukopoïesis - DIFF Double Diff Matrix Absorbance Resistivity
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Leukopoïesis - DIFF Eosinophils Neutrophils Lymphocytes Monocytes
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Leukopoïesis - DIFF Atypical Lymphocytes
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Double Diff Matrix Leukopoïesis - DIFF Large Immature Cells
IMmature Granulocytic line IMmature Monocytic line IMmature Lymphocytic line
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% and # values High precision of the Diagnosis
Leukopoïesis - DIFF Abnormal Neutrophil IMG immature granular Metamyelocyte Myelocyte Promyelocyte % and # values High precision of the Diagnosis Myeloblast
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% and # values High precision of the Diagnosis
Leukopoïesis - DIFF IMM immature monocyte Promonocyte Monoblast % and # values High precision of the Diagnosis
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IML immature lymphocyte
Leukopoïesis - DIFF IML immature lymphocyte Lymphoblast Sezary cell Prolymphocyte % and # values High precision of the Diagnosis
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Additional information provided by Matrix
Leukopoïesis - DIFF Additional information provided by Matrix Detection of platelets aggregates Detection of Nrbc population Detection of lyse resistant cells Detection of band cells
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Evaluations references
ABX PENTRA DX 120: EVALUATION OF THE NEW PARAMETERS A side-by-side comparison with manual slide review (Double Matrix / Erythroblasts) and immunophenotyping (Erythroblasts) Dr. Jose Maria JOU Servei d’Hemostàsia i Hemoteràpia Hospital Clínico Universitario de Barcelona, C/ Villarroel nº170, Barcelona, SPAIN. Myeloid Immaturity and Instrumental Findings AM. Cenci°, B. Casolari°, M. Maconi* °Laboratory of Clinical Pathology, AUSL Agency S. Agostino Hospital, Modena; *Laboratory of Chemical Analysis Clinics, Santa Maria Nuova General Hospital, Reggio Emilia.
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Evaluations references
Evaluation of the ABX Pentra DX 120 Dr. Francis Lacombe Laboratoire d’Hématologie, Hôpital Haut-Lévêque, France New technologies and study of blood cells: the performance of HORIBA ABX PENTRA DX 120 B. Casolaria, M. Maconib, A.M. Cencia aLaboratory of Clinical Pathology, AUSL Agency S.Agostino Hospital, Modena; bLaboratory of Clinical Pathology, O.I.R.M. Hospital Agency - S.Anna, Turin. Detection of atypical lymphocyte populations and lymphoid pathology diagnosis in adults and children (ALY alarm) P. Lemaire, Laboratoire de Longpont-Sur-Orge (91310) Georges Pompidou European Hospital (75015 Paris), France
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Erythropoïesis exploration
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Erythropoïesis - Maturation
The red blood cells line maturation Proerythroblast Basophilic Erythroblast Polychromatophilic Erythroblast Acidophilic Erythroblast Reticulocyte Erythrocyte
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Measurement principles
NRBC’s count (ERB) 1. Specific lyse and fluorochrome a) Lysing of RBC b) Staining of WBC and NRBC’s with Thiazole orange, a fluorochrome specific to nucleic acids (reference method). 2. Double Hydrodynamic Sequential System (DHSS) Flow-cytometer using hydrodynamic focusing before and after the aperture 3. Impedance method Measurement of the cell volume (“X” axis) Argon ion Laser 4. Fluorescence (and forward scatter) DNA content (“Y” axis)
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Erythropoïesis - Erythroblasts
Fluorescence WBC ERB Volume % and # values WBC corrected
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Evaluations references
ABX PENTRA DX 120 : EVALUATION OF THE NEW PARAMETERS A side-by-side comparison with manual slide review (Double Matrix / Erythroblasts) and immunophenotyping (Erythroblasts) Dr. Jose Maria JOU Servei d’Hemostàsia i Hemoteràpia Hospital Clínico Universitario de Barcelona, C/ Villarroel nº170, Barcelona, SPAIN. Automated Nucleated RBC Counting: Comparison to Flow Cytometry. Bruce H. Davis*, Kathleen T. Davis*, Esther Tournier+, Karen Becker* *Trillium Diagnostics, LLC and Maine Medical Center Research Institute, Scarborough, Maine USA +HoribaABX Diagnostics, Montpellier, France
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Erythropoïesis - Maturation
The red blood cells line maturation Proerythroblast Basophilic Erythroblast Polychromatophilic Erythroblast Acidophilic Erythroblast Reticulocyte Erythrocyte
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Erythropoïesis - Reticulocytes
Reticulocyte count 1. Fluorochrome Reticulocytes are stained according to the RNA they contain. 2. Double Hydrodynamic Sequential System (DHSS) Flow-cytometer using double hydrodynamic focusing 3. Impedance method Measurement of the cell volume (“X” axis) Argon ion Laser 4. Fluorescence (and forward scatter) RNA content (“Y” axis)
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Erythropoïesis - Reticulocytes
Volume Fluorescence RET RBC RET H (RNA +++) 3 maturation stages function to the RNA content RET M (RNA ++) RET L (RNA +) IRF -> Immature Reticulocyte Fraction MFI -> Mean Fluorescence Index MRV -> Mean Reticulocyte Volume Monitoring the erythropoietic response CRC -> Corrected Reticulocyte Count Classifying anaemias (central/peripheral - generative or non-generative)
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Evaluations references
The Mean Reticulocyte Volume (MRV) on the HORIBA ABX Pentra 120/DX as an alternative measurement to the Reticulocyte Haemoglobin Content (CHr™ ) A.H. Roderick – Department of Haematology, University Hospital of Wales, Cardiff. UK J.M. Jou – Servei d’Hemoterapia, Hospital Clinic, Barcelona. Spain W.G.B. Rees, E. Thomas – Haematology Department, West Wales General Hospital, Carmarthen. UK Early diagnosis of iron deficiency anaemia by Mean Reticulocyte Volume (MRV) screening Dr.Ruud Muusze, clinical chemist, Ziekenhuis Zeeuws Viaanderen, Terneuzen, Holland.
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Erythropoïesis - Maturation
The red blood cells line maturation Proerythroblast Basophilic Erythroblast Polychromatophilic Erythroblast Acidophilic Erythroblast Reticulocyte Erythrocyte
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Erythropoïesis - Red Blood Cells
Specific quantitative flags: Anemia: Hgb Polyglobulia: RBC Cold agglutinin: MCHC Micro/macrocytosis: MCV Anisocytosis: RDW Reference methods of measurement High precision of the Anemias and RBC pathologies
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Erythropoïesis - Red Blood Cells
Specific morphology flags: MIC: presence of microcytic population MAC: presence of macrocytic population No (noise): presence of lyse resistant cells RBC morphology confirmation of the Diagnosis detection of abnormal RBC pop.
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Erythropoïesis - Red Blood Cells
Specific and precise alarm MIC (3 levels) microcytes, poïkilocytes, schistocytes, spherocytes, drepanocytes, Joly bodies … Specific and precise alarm MAC (3 levels) macrocytes, poïkilocytes, ponctuate basophilia...
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Thrombopoïesis exploration
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Normal platelets population
Thrombopoïesis Normal platelets population Specific MIC flag
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Thrombopoïesis Platelet aggregates Optical detection
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Thrombopoïesis Macroplatelets Macroplatelet detection
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Evaluation references
Evaluation of Platelets count below /L: Hematologic Analyzers ABX Pentra DX 120 versus platelet reference method Dr. Jose Maria JOU Servei d’Hemostàsia i Hemoteràpia Hospital Clínico Universitario de Barcelona, C/ Villarroel nº170, Barcelona, SPAIN.
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Evaluation references
Am J Clin Pathol 115(3): , © 2001 American Society of Clinical Pathologists, Inc
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Evaluation references
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Expert validation station
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Specs & functionality Dedicated PC Windows XP, CD-ROM burner Onboard user manual Mono or bi-directional host connection Connection of 3 ABX analyzers Query mode Download capability
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_ Automatic validation _ Messages, comments….
Specs & functionality User defined rules _ Rerun capability _ Reflex testing _ Automatic validation _ Messages, comments…. Bio-technical validation with : Patient history, delta check Manual entry Recalculation capability Old New D+ D- Delta check
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Specs & functionality results 1 matrix 3 histograms Zoom capability
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Specs & functionality Hematovision IV included A cell cytology library
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SPS EVOLUTION
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Throughput : 120 stained slides per hour Sample volume: 50µl
Specification Throughput : 120 stained slides per hour Sample volume: 50µl Stain : MGG, Wright, Wright-Giemsa User defined smear criteria Smearing profile function to each individual sample and to each hematology parameter Automatic maintenance
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When dispensed, slides are twisted to avoid blockages
Technology Slide stacker capacity of 160 slides When dispensed, slides are twisted to avoid blockages Rack stacker capacity of 8 racks Located outside, slides and racks are easily reloaded at any time
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Titanium coated wedge :
Technology Titanium coated wedge : No change, no adjustment Smearing tape : Moves forward between each sample to avoid contamination and to avoid a complex mechanism to clean and dry the wedge
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User’s defined smearing profile : Technology
- Blood drop volume adjustable by increment of 0,1 µl - 2 smearing angles (40° or 45°) - Waiting time adjustable by increment of 1ms - Smearing speed adjustable by increment of 1step/ms
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Technology
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Slide identification :
Technology Slide identification : 3 lines of 14 alpha-numerical characters Drying process :
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Individual staining wells :
Technology Individual staining wells : Use of fresh stains ensures a good staining stability User defined stain volume Automatic stain dilution Staining steps adjustable by increment of 30s Maximum staining duration of 16mn
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20 slides can collected in one rack
Technology Manual mode : Pre-smeared slide: Bone marrow Biologic fluid Cyto-centrifuging Leuko-concentration Slide outlet : 20 slides can collected in one rack
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Manual smear SPS Evolution Technology Manual identification
Irregular blood films Irregular staining Automatic identification Homogenous blood films Standardization of the staining
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ABX Pentra DX 120 Conclusion Dr. Echevarne laboratory
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Laboratorios Dr. F. Echevarne
Rack Pentra DX+SPS Pentra DX Consolidate Storage Data Base SERVER Validation Station Medical Validation Station ASTM ASTM “Host Query” HORIBA ABX SAT5000 Automatic Tube Sorter & Storage Host Computer Pentra DX Cell Central Laboratory >4.500 Samples/day Satelit Labs. & Clinics 1 site Pentra 80 7 Clinics 2 Satelite Labs. 6 Satelite Labs. 1 Clinics Pentra 60 C+ 5 Clinics 18 x Pentra 80 16 x Pentra 60 C+
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HORIBA ABX ambitious goals will be reached by becoming the
Conclusion HORIBA ABX is differentiating itself from the other “suppliers of systems” in being a “partner providing solutions” for the laboratory. HORIBA ABX ambitious goals will be reached by becoming the “preferred partner” of its customers worldwide.
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Thank you ABX welcomes the SIMeL April 29th, 2004
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