Diagnostic Value of Determination Blast Cell Population Lineage Using WPC Scattergram Hematology Analyzer

Nina Ratnasari, Arifoel Hajat, S. Ugroseno Yudho Bintoro


The diagnosis of hematology malignancies requires examination that includes morphology, immunophenotyping, and cytogenetics. Immunophenotyping is the most trusted examination in determining hematology malignancies lineage, but it is only available in large hospitals and the costs are relatively expensive, so the determination of lineage depends on bone marrow aspiration examination. Therefore it is necessary to have an easier and more reliable alternative to assist BMA morphology. White Precursor Cell (WPC) scattergram Sysmex XN-1000 has the capability to differentiate malignancy lineage. The purpose of this study was to determine the diagnostic value of determining lineage generated by WPC scattergram compared to the lineage from BMA examination. BMA blood samples were simultaneously examined by BMA morphology interpretation using microscope and WPC scattergram Sysmex XN-1000 examination. The hematology malignancies lineage resulting from BMA and WPC scattergram examination was then analyzed statistically to determine the suitability, sensitivity, and specificity. The results of determining the lineage of blast cell population based on WPC scattergram resulted in a suitability with a sensitivity of 93.75% and specificity of 94.74% for determining the hematological malignancy of myeloid lineage and 94.74% and 93.75% for lymphoid lineage, with a diagnostic accuracy of 94.91%. Based on this study it can be concluded that the WPC scattergram can determine the lineage of hematological malignancies with a suitability and high diagnostic value of lineage based on BMA morphology.


White precursor cell scattergram, blast cell population, BMA, myeloid, lymphoid, lineage

Full Text:



Davis AS.,Viera AJ., Mead MD. Leukemia: an overview for primary care. American Family Physician. 2014; 89(9):731-738.

Singh G., Parmar P., Kataria SP., Singh S., Sen R. Spectrum of acute and chronic leukemia at a tertiary care hospital, Haryana India. 2016; 4(4): 1115–1118.

Shahab, F. and Raziq, F. Clinical presentations of acute leukemia. Journal of The College Of Physicians and Surgeon Pakistan. 2014; 24(7):472–476.

Wirawan R. Evaluasi sumsum tulang in Pemeriksaan Laboratorium Hematologi. Edisi Pertama. Jakarta: Badan Penerbit Fakultas Kedokteran Indonesia. 2014; 233-247.

Castro WL., Ibanez GB., Perez MAL., Sanchez AS., Jaloma JC., Garcia EM., Penafiel COR. Morphology of leukaemias. Revista Medica Hospital General Mexico. 2016; 79(2): 107–113.

Pudasaini S., Prasad KBR., Rauniyar SK., Shrestha R., Gautam K., Pathak R., Koirala S., Manandhar U., Shresta B. Interpretation of bone marrow aspiration in hematological disorder. Journal of Pathology of Nepal. 2012; 2: 309–312.

Gajendra S. Flowcytometry in acute leukemia. Department of Pathology and Laboratory Medicine. 2016; (1): 1–5.

Kawauchi S., Kono M., Takagi Y., Wada A., Morikawa Takashi. The Positions of Normal Leukocytes on the Scattergram of the Newly Developed Abnormal Cell-detection Channel of the XN-Series a Multi-parameter Automated Hematology Analyzers. Sysmex Journal International. 2013; 23(1):1–9.

Jones AS., Tailor H., Liesner H., Machin SJ., Briggs CJ. The value of the white precursor cell channel (WPC) on the Sysmex XN-1000 analyser in a specialist paediatric hospital. Journal Clinical Pathology. 2015; (68): 161–165.

Werner PS., Kohlschein P., Maroz A., Linssen J., Dreibiger K., Burstein C., 2016 Performance of the XN-1000 WPC channel- flagging to differentiate reactive and neoplastic leukocytosis. Clinical Chemistry Laboratory Medicine. 2016;1-9.

Sysmex Corporation. White blood cell functionally sensitive assessment of WBC functionality and greater workflow efficiency. Sysmex white paper White Blood Cell Functionality. 2017; 1-7.

DOI: http://dx.doi.org/10.24293/ijcpml.v26i3.1585


  • There are currently no refbacks.

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.