Antibody Therapy for Blood Cancers — The Original Immunotherapy

Not everyone with a blood cancer can have antibody therapy. Eligibility is decided by a marker on the surface of your cancer cells, not by the name on the diagnosis. If the biopsy and flow cytometry reports do not show that marker, the antibody has nothing to attach to, and it is not offered.

We put this first deliberately. Families arrive having read that immunotherapy is available for blood cancers and assume it applies to them. Sometimes it does. Often it does not, and finding that out in the second consultation rather than the tenth saves money, time and a great deal of distress.

You are not a candidate if

• Your cells do not carry the target — most T-cell lymphomas and many myeloid leukaemias do not carry the B-cell marker that the commonest antibodies are built against.
• The report has not been done yet — immunohistochemistry or flow cytometry has to confirm the marker before anyone can say yes. A clinical impression is not enough.
• There is an active, untreated infection — treatment is usually postponed until it is controlled. Untreated hepatitis B has to be covered with an antiviral first, because these antibodies can allow it to reactivate.
• You had a severe reaction to the same antibody before — a previous serious allergic reaction generally rules out rechallenge with that agent.
• You are hoping for the newest classes — bispecific antibodies are used mainly in relapsed or refractory disease, with step-up dosing under monitoring at designated centres. Most newly diagnosed patients are not candidates for them.
• You are asking about CAR-T — that is cell therapy, not antibody therapy. It applies to a narrow set of relapsed blood cancers, and CION does not provide or stock CAR-T or any cell therapy product. Nor does CION perform stem-cell transplant. Where either is genuinely relevant, we refer you to a designated centre that provides it.

If the marker is present, the picture changes. For most B-cell lymphomas and several B-cell leukaemias, adding an antibody to chemotherapy has been the standard approach in NCCN and ESMO guidance for years, and it is one of the few parts of blood-cancer treatment where the medicine is aimed at the cancer cell rather than at every dividing cell in the body.

Antibody therapy uses laboratory-made copies of an immune protein that lock onto one specific marker on the surface of cancer cells. Once attached, the antibody flags the cell for your own immune system to destroy, blocks a signal the cell depends on, or carries a drug payload directly to it. It works only if your cells carry that marker.

1. 1

   The marker is identified

   Your biopsy is stained in the laboratory, or blood and marrow are run through flow cytometry. The report lists which surface markers your cancer cells carry. That list is what decides everything that follows.

2. 2

   The antibody finds and holds the cell

   An antibody is a Y-shaped protein your body already makes to tag things for removal. These are made in a laboratory to tag one marker only. Cells without that marker are largely left alone, which is the whole point of the class.

3. 3

   Your immune system does the work

   Immune cells and immune proteins recognise the tagged cell and destroy it. This is why the class counts as immunotherapy. The medicine points; your immune system acts.

4. 4

   Some antibodies carry something extra

   An antibody-drug conjugate has a chemotherapy drug attached to it and releases that drug inside the cell it has entered. A bispecific antibody grips a T cell with one arm and the cancer cell with the other, so the two are held together. Same targeting idea, different mechanism after the landing.

5. 5

   Healthy cells with the same marker go too

   The marker is not unique to cancer. Normal immune cells of the same family carry it and are cleared as well. That is the origin of the infection risk described further down this page, and it is worth understanding before you start rather than afterwards.

Mechanism described in line with NCCN and ESMO patient-education material. This page names classes of medicine and their targets, not individual products, because product choice, approval status and pricing differ and are decisions for your treating team.

Most antibody therapy is given as a slow drip into a vein in the day-care unit, on the same day as the rest of your cycle. The first dose is deliberately slow and closely watched. Later doses usually run faster. Some antibodies can be given as an injection under the skin in minutes.

1. 1

   Before the first dose

   Blood counts, kidney and liver tests, and hepatitis B screening are done. The marker is confirmed on the pathology report. Nothing starts until those are back.

2. 2

   Premedication, 30 to 60 minutes ahead

   Paracetamol and an antihistamine are standard, and a steroid is often added. This is not a formality — it measurably reduces first-dose reactions. Do not skip it because you feel well.

3. 3

   The first infusion runs slowly

   The drip is started at a low rate and stepped up only if nothing happens. Pulse, blood pressure and temperature are checked at intervals. Set aside most of the day for it. Bring someone with you.

4. 4

   Speak up during the infusion

   Tell the nurse straight away about chills or shivering, fever, itching, a rash, throat tightness, breathlessness, back pain or dizziness. Slowing or pausing the drip settles most reactions. There is no benefit in waiting to see.

5. 5

   Later cycles are quicker

   Once a first dose has been tolerated, the rate is usually increased and the visit shortens considerably. Some antibodies can then be switched to an injection under the skin, which takes minutes rather than hours.

6. 6

   Cycles, then response assessment

   Cycles are usually two to four weeks apart, matched to the chemotherapy schedule. Response is assessed partway through and again at the end, commonly with a PET-CT. CION coordinates response-assessment PET-CT at partner imaging centres rather than owning the scanner.

The first dose is where nearly all infusion reactions happen, and knowing what one feels like takes most of the fear out of it — read what a first-dose infusion reaction actually feels like and how the team handles it before you come in.

Call the team the same day, do not wait for the next appointment, if you have a temperature of 38°C or above, new breathlessness, a rash that is spreading, shivering attacks at home, or new confusion. Our helpline runs day and night: 1800 202 8726. If you cannot reach anyone and you are unwell, go to the nearest emergency department and tell them you are on antibody therapy.

Classes and targets only — no products are named or compared here. Which class applies to you depends on your subtype, your markers and your previous treatment, and is a tumour-board decision.

Cost depends entirely on which class you need, and the range across the four classes is enormous. The older plain-antibody class is now considerably cheaper in India than it once was, because biosimilar versions have been marketed for several years. The newer bispecific class, and cell therapy, sit at the opposite end and are among the most expensive treatments in Indian oncology.

We will not print a number against a class on a public page, because the honest figure depends on your weight, your subtype, the number of cycles, whether it is given with chemotherapy, and which brand your team selects. Any figure you are quoted anywhere should be treated as indicative only, as of August 2026. What you should expect from us instead is a written, itemised estimate before you start, and a clear answer on whether your insurance policy or a government scheme covers it in your situation.

What CION does, and what we refer out

• Given at CION — immunotherapy, including antibody infusions, is administered as day care at our centres, with a medical oncologist and trained day-care nursing on site.
• Coordinated with partners — response-assessment PET-CT is arranged at partner imaging centres. CION does not own the scanner, and we say so rather than implying otherwise.
• Referred to a designated centre — CION does not provide, administer or stock CAR-T or any cell therapy product, and does not perform stem-cell transplant. Where either is the right treatment, our tumour board says so and refers you to a centre that provides it, and we continue to support you around that.

Coverage under Aarogyasri, CGHS, ECHS, ESI and private insurance differs by scheme, by package and by subtype. Ceilings change. Ask for the current position in writing rather than relying on what applied to someone else last year.

• Fertility, before the first cycle — sperm banking or egg and embryo freezing has to be arranged before treatment begins, and the window is often days rather than weeks. Raise it at the first consultation even if nobody else does. What fertility preservation before blood cancer treatment involves sets out the timing and the options.
• Late effects, planned for from the start — low antibody levels, vaccination timing, thyroid and heart follow-up, and second-cancer surveillance all belong in a survivorship plan rather than being remembered years later. Late effects after lymphoma immunotherapy in young adults covers what to ask for.
• Say honestly what the evidence does not cover — long-term data on the newest classes is genuinely immature. Very-long-term immune effects, fertility outcomes and second-cancer risk after the newer antibody classes are not fully known, and any source that sounds certain about them is overstating what has been published.
• Tell every doctor you see — for years afterwards, any dentist, surgeon or physician treating you needs to know you have had antibody therapy, because it changes how infections and vaccinations are handled.

Read next

• Infusion Reactions With Antibody Therapy: The First Dose — what a reaction feels like, what the nurse does, and why it almost never stops treatment.
• Immunotherapy for Lymphoma in Young Adults: Late Effects — the follow-up plan that should be written down before you finish treatment.
• Fertility Preservation Before Blood Cancer Immunotherapy — the conversation to have in the first week, not the second month.
• Immunotherapy at CION Cancer Clinics — the hub page, covering eligibility, marker testing, day-care administration and cost.

This page is general information and does not replace a consultation. It describes classes of medicine and their targets, not individual products, and makes no comparison of efficacy between products. Whether any of it applies to you depends on your pathology report and is a decision for your treating oncologist.

Most families are never told the injection is immunotherapy

It is a fair thing to be confused about, and it deserves a proper explanation rather than a nod. Our team will take the time to show you the marker on your own report and what follows from it.