Impaired immunity in late stage cancer patients is not limited to anti-tumor responses, as demonstrated by poor vaccination protection and high susceptibility to infection 1 – 3 . This has been largely attributed to chemotherapy-induced impairment of innate immunity such as neutropenia 2 , whereas systemic effects of tumors on hematopoiesis and adoptive immunity remain incompletely understood. Here we observed anemia associated with severe deficiency of CD8 + T cell responses against pathogens in treatment-naïve mice bearing large tumors. Specifically, we identify CD45 + erythroid progenitor cells (CD71 + TER119 + , EPCs) as robust immunosuppressors. CD45 + EPCs, induced by tumor growth-associated extramedullary hematopoiesis, accumulate in the spleen to become a major population, outnumbering regulatory T cells (Tregs) and myeloid-derived suppressor cells (MDSCs). The CD45 + EPC transcriptome closely resembles that of MDSCs, and, like MDSCs, reactive oxygen species production is a major mechanism underlying CD45 + EPC-mediated immunosuppression. Similarly, an immunosuppressive CD45 + EPC population was detected in cancer patients with anemia. These findings identify a major population of immunosuppressive cells that likely contributes to the impaired T cell responses commonly observed in advanced cancer patients.

Complement aids in the construction of an immunosuppressive tumor microenvironment. Tumor cell-derived C3 has been previously reported, but whether and how it acts on antitumor immunity remains to be elucidated. Here, we describe a mechanism for tumor cell-derived C3 in suppressing antitumor immunity. Tumor cell-derived C3 was activated intracellularly, which results in generation of C3a. C3a modulated tumor-associated macrophages via C3a-C3aR-PI3Kg signaling, thereby repressing antitumor immunity. Deletion of C3 in tumor cells that had high C3 expression enhanced efficacy of anti-PD-L1 treatment. Collectively, our results suggest tumor cell-derived C3 may be a useful target for cancer immunotherapy and that targeting C3 in tumor cells may enhance antitumor immunity.

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Our data suggest that immunopositivity of p14ARF together with a low expression of MDM2 contributes to accumulation of the wild-type p53, and that deregulation of the p53-MDM2-p14ARF pathway is important in the pathogenesis and outcome of a subset of NSCLC.