1. Showdown at the FLOW-K Corral
Presented by Patti Chiurazzi
Johns Hopkins Medical Institutions

2. FLOW CYTO METRY What is Flow Cytometry? Technology that measures
characteristics of cells
as they flow single-file through in a fluid stream through a beam of laser light

3. What is Flow Cytometry?
Hematologic cells are characterized by antigen on their surface.
Antibodies to these antigens can be compounded with a fluorescent dye which is excited by a laser.
When these antibodies are added to cell solution, the presence of the antigen on a cell surface can be detected by the fluorescent signal.
Due to differences in spectral emissions, different fluorescent dyes can be used in one tube…meaning multiple cell surface antigens can be measured in one tube.

4. JHMI Flow Cytometry Lab
Becton Dickinson Instrumentation
3 FacsCantos
SPA (Sample Prep Assistant)
Analysis software Paint A Gate and Infinicyt
Leukemia/ Lymphoma Phenotyping (~ 400 cases monthly)
Lymphocyte Subsets (~650)
PNH
Quantitative CD34

5. Before Soft Flow Cytometry
TEDIOUS paperwork

6. Before Soft Flow Cytometry
Manual transcription of patient/testing information
Raw data sheet with
many initials
Tube labels with hand
written identification
Transcription of all
data into Access database
Lost paperwork? Rework the sample!

7. Implementation of Soft Flow Cytometry
Soft LAB 4.5.2
Soft FLW

8. Implementation of Soft Flow Cytometry
Lots and Lots of Building
Need the fence posts in order to build the fence

9. Implementation of Soft Flow Cytometry
Antigen
+ Fluorochrome
= Marker
Marker + Marker+ Marker … = Panel tube

10. BUILDING SETUP FILES-SPECIMENS
SETUP>>SETUP FILES>>SPECIMEN

11. BUILDING SETUP FILES-ANTIGENS
SETUP>>SETUP FILES>>ANTIGEN files

12. BUILDING SETUP FILES- RESULT ELEMENTS
SETUP>>SETUP FILES>>RESULT ELEMENTS
100+ files

13. BUILDING SETUP FILES- FLUOROCHROMES
SETUP>>SETUP FILES >> FLUOROCHROME

14. BUILDING SETUP FILES
SETUP>>SETUP FILES>>TESTS>>MARKERS

15. BUILDING SETUP FILES
SETUP>>SETUP FILES>>TESTS>>PANELS

16. More building and dependent files
BUILDING SETUP FILES
More building and dependent files
Actions- anything wanted to be documented in the system
Protocols- actions grouped together for specific workflows for certain specimens (specimen protocols) or tests (test or panel protocols)

17. SETUP>>SETUP FILES>>ACTION
!REV Test Review
FLACQUIRE Acquire on Instrument

18. SETUP>>SETUP FILES>>PROTOCOL
BMSPROC Bone Marrow Specimen Processing
FLCLINICAL Leukemia/Lymphoma Panel Protocol

19. SETUP>>SETUP FILES>>PROTOCOL
AB_ADD Antibodies Added
FLACQUIRE Acquire on Instrument
FLANALYZE Transfer FSC Files
!PARV Panel Review

20. DMI>>INSTRUMENT SETUP>>DIVAS
DIVAS Instrument looking for Order#_Panel Code_Tube#

21. DMI>>INSTRUMENT SETUP>>DIVAS
DIVAS Instrument moves FSC File from FCS FILES folder to INFINICYT folder

22. DMI>>INSTRUMENT SETUP>>DIVAS
FLANALYZE action is completed by DIVAS

23. DMI>>INSTRUMENT SETUP>>DIVAS
Antibodies added and Acquire on Instrument are completed by a tech
Transfer FSC files is completed by DIVAS

24. DMI>>INSTRUMENT SETUP>>INFINICYT
Instrument Infinicyt looks for Order#_Panel Name_Run#

25. DMI>>INSTRUMENT SETUP>>INFINICYT
Infinicyt is started by clicking Analysis Module button

26. DMI>>INSTRUMENT SETUP>>INFINICYT
The panel name will dictate which analysis profile to use.
MDS panel will use the MDS123.inp

27. DMI>>INSTRUMENT SETUP>>INFINICYT
Populations from Infinicyt result page are mapped to SOFT result fields.
From MDS tube 001- RE%MYELOID result field is populated.

28. DMI>>INSTRUMENT SETUP>>INFINICYT

29. DMI>>INSTRUMENT SETUP>>INFINICYT

30. DMI>>INSTRUMENT SETUP>>INFINICYT
INFINICYT instrument moves XML file from INFINICYT_RESULTS to INFINICYT_ARCHIVE

31. Implementation of Soft Flow

32. Implementation of Soft Flow
Tube labels print with patient and antibody information
Label BARCODES (scan sample information directly into instruments)

33. Implementation of Soft Flow
Previous history of patient in same system
Automatic release of results into HIS

34. The Calm FLOW Frontier
FLW

35. SOFT FLOW 3.2.19.6 SOFT LAB/MIC 4.5.4 SOFT MOLECULAR SOFT CYTOGENETICS
SOFT TQC functionality with SOFT FLW

36. THE UPGRADE
FLW

37. UPGRADE to
System slowness. Pathologists finding delays going from one screen to the other during the signout process.  
Interpretation windows “freezing”
SoftFlowcytometry.exe has stopped working.
Doctor file not updating with roles- order cannot be saved in GENE
Big Red X

38. BIG RED X

39. TQC in SOFT FLOWCYTOMETRY
The concept of TQC for creating orders and saving results for statistical analysis is a good concept for LAB.
TQC will not allow the ordering of panels which is the basis of the FLW module.
TQC will only allow 1 tube to associate with each QC order.
TQC is not setup to use result element reporting.
TQC does not allow analysis of the order in the FLW module or automatic saving of documents.

40. TQC in SOFT FLOW CYTOMETRYX
TQC in SOFT FLOW CYTOMETRY
The concept of TQC for creating orders and saving results for statistical analysis is a good concept for LAB.
TQC will not allow the ordering of panels which is the basis of the FLW module.
TQC will only allow 1 tube to associate with each QC order.
TQC is not setup to use result element reporting.
TQC does not allow analysis of the order in the FLW module or automatic saving of documents.