Objective To analyze the clinical characteristics of de novo primary AML patients with higher blast cell ratio in peripheral blood than bone marrow and its relationship with CR1. Methods The clinical data on de novo primary AML patients in Henan Provincial Tumor Hospital from January 2015 to December 2016 were ret-rospectively reviewed. Based on the proportion of blast cells in the peripheral blood and bone marrow ,the patients were divided into BHG and NBHG. All the data was analyzed respectively by Schisquare test ,rank sum test or Spearman correlation analysis according to the types of clinical data. Results As compared with NBHG patients , BHG patients had a higher rate of bleeding,palpitation,M2 subtype,FLT3-ITD mutation,and average level of LDH andα-HBDH in serum before treatment,and the difference was statistically significant(P<0.05);however, the rate of CR1,M3 and M5 subtype in BHG patients was lower than that in NBHG patients,and the difference was statistically significant(P < 0.05). The proportion of peripheral blood blast cells in patients with AML has a positive correlation with serum levels of LDH and α-HBDH(R:0.331 and 0.352,P < 0.05). Conclusions De novo primary AML patients with higher blast cell ratio in peripheral blood than bone marrow are mostly M2 subtype,easily associated with FLT3-ITD mutation,bleeding and palpitation symptoms,and they have a lower CR1rate. The proportion of blast cells in peripheral blood is positively correlated with levels of serum LDH and α-HBDH.