| Sumario: | Myeloid malignancies are clonal diseases originated in myeloid hematopoietic stem cells that are frequently initiated by somatic mutations. The detection of genetic alterations has considerably improved the diagnostic accuracy in myeloid neoplasms, however multiple aspects should be further improved in the diagnostic and classification tools that are used in clinical practice. The main goal of the research projects presented in this thesis is to improve the accuracy of the diagnosis and classification of myeloid malignancies, focused on myeloproliferative neoplasms (MPN), myelodysplastic syndromes (MDS) and chronic myelomonocytic leukemia (CMML). We explored the role of cell free DNA (cfDNA) analysis as a new non-invasive diagnostic tool in MPN and MDS patients and detected an equivalent mutational profile in paired samples of cfDNA and tumoral cells. On the other hand, we compared the clinical, genomic, and immunophenotypic features of a series of oligomonocytic CMML (OM-CMML) and overt CMML and observed similar characteristics supporting the consideration of OM-CMML as a distinctive subtype of CMML. Finally, we assessed if saliva samples and CD3+ lymphocytes were a suitable source of germline DNA in MPN patients, and found that the use CD3+ lymphocytes was a better option for germline DNA obtention than saliva samples, which were frequently contaminated with tumoral cells.
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